McCune-Albright Syndrome in Conjunction With Acromegaly and Subclinical Hyperthyroidism

This paper describes a case of McCune-Albright syndrome associated with the rare complication of acromegaly and asymptomatic nonautoimmune hyperthyroidism. A case is reported, and the pertinent literature is reviewed. A 25-year-old man with documented severe McCune-Albright syndrome presented with worsening prognathism and frontal bossing. Physical examination revealed acromegalic features and stigmas of underlying McCune-Albright syndrome, including orbital asymmetry, proptosis, limb length discrepancy, and a large cafe au lait spot on his left scapula. No thyromegaly was evident on palpation. Insulin-like growth factor (IGF-I) and growth hormone (GH) levels were high and failed to suppress after a standard oral glucose tolerance test. Magnetic resonance imaging of the sella revealed a 5-mm pituitary microadenoma. McCune-Albright syndrome is a rare sporadic condition characterized by skin dysplasia with cafe au lait spots, polyostotic fibrous dysplasia, precocious puberty, and multiple autonomous endocrinopathies. To date, a complex combination of multiple endocrine abnormalities has been described in association with this syndrome.