Li Ping, Zhang Zai-Ren, Jiang Ying, Xia Xu-Dong, Wang Dan, Li Xian-Feng
Department of Radiology, the Second Affiliated Hospital, Harbin Medical University, 246 Xue Fu Road, Harbin, Heilongjiang, 150086, China.
Cases J. 2009 Dec 22;2:9376. doi: 10.1186/1757-1626-2-9376.
McCune-Albright syndrome (MAS) is a rare disorder characterized by the classic triad of precocious puberty, polyostotic fibrous dysplasia and café-au-lait pigmented skin lesions. Cystic change is rare in fibrous dysplasia (FD), especially in McCune-Albright syndrome. There were no reports about cyst degeneration in MAS which resulted in abnormal visual acuity and visual fields. Herein, we report a female patient with MAS associated with sphenoid bone cysts which resulted in visual deterioration to describe the computed tomography (CT) and magnetic resonance (MR) imaging findings of cyst degeneration in McCune-Albright syndrome.
A 20-year-old female presented with right temporal hemianopsia and visual loss in the right eye suddenly. A café-au-lait spot was found on her neck and left shoulder. Endocrinologic examination revealed elevated basal level of serum PRL, FT(3 )and FT(4 )with decreased serum TSH. Fibrous dysplasia (FD) generally manifest as round-glass appearance with well defined borders and cystic areas within involved bone were seen as hypointensity on CT. They were showed as hypointense in T1-weighted sequences and as hyperintense in T2-weighted sequences of MRI. After surgery the right temporal hemianopsia improved.
CT combined with MRI is the most effective method to evaluate the extent and complications of fibrous dysplasia in patients with MAS. The treatment of surgery can not cure MAS but relieve the symptom.
McCune-Albright综合征(MAS)是一种罕见疾病,其特征为性早熟、多骨纤维发育不良和咖啡斑色素沉着性皮肤损害这一经典三联征。纤维发育不良(FD)中囊性变罕见,尤其是在McCune-Albright综合征中。尚无关于MAS中囊肿退变导致视力和视野异常的报道。在此,我们报告一名患有与蝶骨囊肿相关的MAS的女性患者,其因囊肿退变导致视力下降,以描述McCune-Albright综合征中囊肿退变的计算机断层扫描(CT)和磁共振(MR)成像表现。
一名20岁女性突然出现右侧颞侧偏盲和右眼视力丧失。在她的颈部和左肩发现一个咖啡斑。内分泌检查显示血清PRL、FT(3)和FT(4)基础水平升高,血清TSH降低。纤维发育不良(FD)在CT上通常表现为边界清晰的圆形玻璃样外观,受累骨内的囊性区域呈低密度。在MRI的T1加权序列中它们呈低信号,在T2加权序列中呈高信号。手术后右侧颞侧偏盲有所改善。
CT联合MRI是评估MAS患者纤维发育不良范围和并发症的最有效方法。手术治疗不能治愈MAS,但可缓解症状。