Mazabraud’s syndrome in female patients: Two case reports

Xiu-Mao Li, Ze-Hao Chen, Ke-Yi Wang, Jun-Nan Chen, Zhao-Nong Yao, Yu-Hong Yao, Xiao-Wei Zhou, Nong Lin
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Abstract

BACKGROUND Mazabraud’s syndrome (MS) is a rare and slowly progressive benign disease characterized by the concurrent presence of fibrous dysplasia of bone and intramuscular myxoma, and is thought to be associated with mutations of the GNAS gene. To date, only about 100 cases of MS have been reported in the literature, but its standard treatment strategy remains unclear. CASE SUMMARY We report two cases of MS in young women who underwent different treatments based on their symptoms and disease manifestations. The first patient, aged 37, received internal fixation and intravenous bisphosphonate for a pathological fracture of the right femoral neck, excision of a right vastus medialis myxoma was subsequently performed for pain control, and asymptomatic psoas myxomas were monitored without surgery. Genetic testing confirmed a GNAS gene mutation in this patient. The second patient, aged 24, underwent right vastus intermedius muscle myxoma resection, and conservative treatment for fibrous dysplasia of the ilium. These patients were followed-up for 17 months and 3 years, respectively, and are now in a stable condition. CONCLUSION Various treatments have been selected for MS patients who suffer different symptoms. The main treatment for myxomas is surgical resection, while fibrous dysplasia is selectively treated if the patient experiences pathological fracture or severe pain. However, given the documented instances of malignant transformation of fibrous dysplasia in individuals with MS, close follow-up is necessary.
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女性患者的马扎布洛综合征:两份病例报告
背景 马扎布洛综合征(MS)是一种罕见的缓慢进展性良性疾病,其特点是同时存在骨纤维发育不良和肌内肌瘤,被认为与 GNAS 基因突变有关。迄今为止,文献中仅报道了约 100 例 MS 病例,但其标准治疗策略仍不明确。病例摘要 我们报告了两例年轻女性多发性硬化症患者,她们根据自己的症状和疾病表现接受了不同的治疗。第一例患者 37 岁,因右股骨颈病理性骨折接受了内固定和静脉注射双膦酸盐治疗,随后为控制疼痛切除了右股内侧肌瘤,并对无症状的腰肌肌瘤进行了监测,但未进行手术。基因检测证实该患者存在 GNAS 基因突变。第二名患者 24 岁,接受了右侧阔中肌肌瘤切除术,并接受了髂骨纤维发育不良的保守治疗。这两名患者分别接受了 17 个月和 3 年的随访,目前病情稳定。结论 针对不同症状的多发性硬化症患者选择了不同的治疗方法。肌瘤的主要治疗方法是手术切除,而纤维发育不良则在患者出现病理性骨折或剧烈疼痛时选择性治疗。然而,鉴于纤维发育不良在多发性硬化症患者中发生恶性转化的记录在案,有必要进行密切随访。
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