title: Pamidronic acid and cabergoline as effective long-term therapy in a 12-year-old girl with extended facial polyostotic fibrous dysplasia, prolactinoma and acromegaly in McCune-Albright syndrome: a case report.
abstract: BACKGROUND
  McCune-Albright syndrome is a complex inborn disorder due to early embryonal postzygotic somatic activating mutations in the GNAS1 gene. The phenotype is very heterogeneous and includes polyostotic fibrous dysplasia, typically involving the facial skull, numerous café-au-lait spots and autonomous hyperfunctions of several endocrine systems, leading to hyperthyroidism, hypercortisolism, precocious puberty and acromegaly.
  
  
  METHODS
  Here, we describe a 12-year-old Caucasian girl with severe facial involvement of fibrous dysplasia, along with massive acromegaly due to growth hormone excess and precocious puberty, with a prolactinoma. Our patient was treated with a bisphosphonate and the prolactin antagonist, cabergoline, resulting in the inhibition of fibrous dysplasia and involution of both the prolactinoma and growth hormone excess. During a follow-up of more than two years, no severe side effects were noted.
  
  
  CONCLUSIONS
  Treatment with bisphosphonates in combination with cabergoline is a suitable option in patients with McCune-Albright syndrome, especially in order to circumvent surgical interventions in patients suffering from polyostotic fibrous dysplasia involving the skull base.
authors.affiliation: University Children's Hospital, Ernst-Heydemann-Strasse 8, D-18057 Rostock, Germany. cfclassen@gmx.de.
authors.forename: Carl Friedrich
authors.initials: CF
authors.lastname: Classen
authors.forename: Monika
authors.initials: M
authors.lastname: Mix
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kyank
authors.forename: Christina
authors.initials: C
authors.lastname: Hauenstein
authors.forename: Dieter
authors.initials: D
authors.lastname: Haffner