A lethal form of Gorham disease associated with extensive musculoskeletal pneumatosis: case report and review of the literature

Viewpoints on vessels and vanishing bones in Gorham-Stout disease

Gorham-Stout disease (GSD) is a rare disorder characterized by the proliferation of endothelial-lined vessels in bone and the progressive destruction of bone. Although Jackson described the first case of GSD in 1838, the clinical and histological features of GSD were not defined until Gorham and Stout published their report on massive osteolysis in 1955. In the years since Gorham and Stout's groundbreaking publication, more than 300 cases of GSD have been described in the literature. These reports have revealed that the progressive resorption of bone in GSD causes severe physical deformities, disabilities, and life-threatening complications. Unfortunately, the underlying cause of GSD remains unknown and, as a result, the therapeutic options for individuals with GSD are limited. Here we review the latest advances in GSD research and present strategies to address basic and clinical research questions related to GSD.

Gorham's Disease complicated with bilateral chylothorax and successfully treated with Interferon-alpha-2a

Gorham's disease (GD) is rare and characterized by non-neoplastic lymphovascular proliferation and massive osteolysis. Its clinical course is usually protracted, but sometimes life threatening when vital structures are involved or when complicated with chylothorax. There is no optimal treatment guideline for GD complicated with chylothorax. Surgical ligation of thoracic duct, pleurectomy, pleurodesis, interferon-alpha-2b, and radiotherapy, are reported to manage chylothorax. We present the case of a 32-year-old man with Gorham's disease complicated by bilateral chylothorax, which was refractory to radiotherapy but remitted dramatically two weeks after interferon-alpha-2a therapy. The patient was free of relapse four months after discontinuing four-month interferon therapy. To date, only 11 cases (including ours) of GD with chylothorax have received interferon as single or salvage therapy, and 10 of them survived. Early intervention with interferon therapy can be considered as an effective treatment for GD complicated with bilateral chylothorax.

Isolated femoral osseous megalymphatics with chylous reflux: case report and review of the literature

We report here the clinical and imaging findings of marked dilatation of the intraosseous lymphatic vessels, "megalymphatics," with chylous reflux presenting with pain and extensive lytic changes in a femoral bone of a child. Multimodality imaging findings, including radiographs, magnetic resonance imaging, ultrasound, scintigraphy and percutaneous osseous lymphangiography are described.

Gorham-Stout disease and cerebrospinal fluid otorrhea

OBJECTIVE AND IMPORTANCE

Gorham-Stout disease is a rare entity characterized by vascular proliferation causing local destruction of bone tissue. Owing to its low incidence and variable clinical presentation, the diagnosis requires a high degree of awareness by the clinician.

CLINICAL PRESENTATION

We present the case of a 2-year-old boy diagnosed of Gorham-Stout syndrome with involvement of the temporal bone and secondary cerebrospinal fluid (CSF) leakage.

INTERVENTION

Because of the CSF leakage, the patient required two surgical interventions. The second intervention included mastectomy and placement of a patch and a lumbar drainage device during 50 days, after which the leakage ceased.

CONCLUSION

Gorham-Stout disease is a rare condition that can affect the skull base and even present with CSF leakage.