Fibrous Dysplasia of Bone and McCune-Albright Syndrome: A Bench to Bedside Review

Calcif Tissue Int. 2019 May;104(5):517-529. doi: 10.1007/s00223-019-00550-z. Epub 2019 Apr 29.


Fibrous dysplasia is an uncommon mosaic disorder in which bone is replaced by structurally unsound fibro-osseous tissue. It is caused by the sporadic post-zygotic activating mutations in GNAS, resulting in dysregulated GαS-protein signaling in affected tissues. This manifests on a broad clinical spectrum ranging from insignificant solitary lesions to severe disease with deformities, fractures, functional impairment, and pain. Fibrous dysplasia may present in isolation or in association with hyperfunctioning endocrinopathies and café-au-lait macules, known as McCune-Albright Syndrome. This review summarizes the current understanding of pathophysiology in fibrous dysplasia, describes key pre-clinical and clinical investigations, and details the current approach to diagnosis and management.

Keywords: Bone disorders; Bone metabolism; FGF23-mediated hypophosphatemia; McCune–Albright syndrome.

Publication types

  • Review

MeSH terms

  • Animals
  • Bone and Bones / pathology
  • Cafe-au-Lait Spots
  • Cartilage Diseases
  • Cell Transformation, Neoplastic
  • Chromogranins / genetics
  • Disease Progression
  • Fibroblast Growth Factor-23
  • Fibrous Dysplasia of Bone
  • Fibrous Dysplasia, Polyostotic / diagnosis*
  • Fibrous Dysplasia, Polyostotic / genetics*
  • GTP-Binding Protein alpha Subunits, Gs / genetics
  • Genetic Predisposition to Disease
  • Humans
  • Interleukin-6 / genetics
  • Mutation*
  • Signal Transduction
  • Skin Diseases / complications
  • Translational Research, Biomedical


  • Chromogranins
  • FGF23 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Fibroblast Growth Factor-23
  • GNAS protein, human
  • GTP-Binding Protein alpha Subunits, Gs