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Published on: September 20, 2018
Gorham-Stout Disease: A Case Report and Review of the Literature
Bedirhan Albayrak1, Şafak Aydın Şimşek1, Tolgahan Cengiz1
1Department of Orthopaedics and Traumatology, Ondokuz Mayıs University, Faculty of Medicine, Samsun, TUR.
Insights
Gorham-Stout disease, a rare condition causing bone loss from lymphatic vessel overgrowth, has unclear causes. This case report shows successful pharmacological treatment, achieving local disease control without surgery.
Area of Science:
- Medicine
- Pathology
- Radiology
Background:
- Gorham-Stout disease is a rare condition characterized by progressive osteolysis due to abnormal lymphatic vessel proliferation.
- The exact etiopathology of Gorham-Stout disease is not fully understood, complicating diagnosis and treatment.
- Radiographic findings of massive osteolysis can mimic tumoral conditions, necessitating a thorough differential diagnosis.
Observation:
- This case report details a patient diagnosed with Gorham-Stout disease.
- The patient was managed using pharmacological treatment methods as a first-line approach.
- The disease's progression was monitored over a one-and-a-half-year follow-up period.
Findings:
- Pharmacological treatment led to successful local control of Gorham-Stout disease.
- No surgical intervention was required to manage the condition in this case.
- This outcome suggests the potential efficacy of pharmacological management in select cases.
Implications:
- This case highlights the effectiveness of pharmacological interventions for Gorham-Stout disease, potentially avoiding surgical procedures.
- Further research into the etiopathology and standardized treatment protocols for Gorham-Stout disease is warranted.
- Early consideration of Gorham-Stout disease in the differential diagnosis of massive osteolysis is crucial for timely and appropriate management.
Abstract:
Gorham-Stout disease causes gradual bone loss (osteolysis) due to an abnormal overgrowth of lymphatic vessels. This rare disease is usually seen in younger people. The etiopathology of Gorham-Stout disease remains unclear. The disease is pathologically characterized by the proliferation of the vascular or lymphatic vessels and, finally, bone matrix destruction. These pathological changes lead to the presence of massive osteolysis on plain radiographs. Thus, plain radiograph findings may lead physicians to consider tumoral conditions, especially metastasis. There are several other conditions on the differential diagnosis list of massive osteolysis, such as metabolic, infectious, malignant, and immunological conditions. After excluding all possible disorders, the disease can be considered in the differential diagnosis. The treatment of the disease is symptom-based, but there is no consensus. Pharmacological methods should be considered first-line treatment. If there is no regression in the course of the disease despite pharmacological treatment, radiotherapy and resection arthroplasty are the treatment of choice in the later stages. In this case report, we present a case of Gorham-Stout disease, which was treated by pharmacological methods. During the one and half year follow-up, the local control of the disease was achieved without any surgical intervention.
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