Progressively bilateral resorption of the mandible

Radiographic extent of maxillofacial Gorham's disease and its impact on recurrence: A systematic review

OBJECTIVE

This systematic review assessed the radiographic extent of maxillofacial Gorham's disease and its impact on recurrence.

STUDY DESIGN

PubMed and Cochrane databases were searched. The key words were (Gorham Disease OR Vanishing Bone Disease OR Gorham Stout Syndrome) AND (Jaw OR Maxilla OR Mandible OR Maxillofacial).

RESULTS

Forty-one cases from 39 articles were included. Based on radiographic extent, the lesions were classified as large or small. Most cases occurred in the mandible (24), followed by a combination of maxilla and/or mandible and other bones (12), both mandible and maxilla (3), and maxilla only (2). Only mandibular cases were analyzed for radiographic extent. Of the 24 mandibular lesions, 16 were large and 8 were small. Nine of the large lesions occurred in the young age group with 2 recurrences, followed by 5 in the middle-aged group with 1 recurrence. Small lesions were nearly equally distributed over the age groups, with 2 recurrences in the middle-aged group and 1 recurrence in the adult age group. Age, sex, and lesion size had no significant effect on recurrence.

CONCLUSIONS

Radiographic extent of the lesion does not impact recurrence, suggesting a possible existence of aggressive and nonaggressive variants of maxillofacial Gorham's disease.

Case Report: Gorham-Stoute Syndrome with Involvement of Majority of Mandible, and Partial Maxillary, Temporal and Zygomatic Bones

The Gorham-Stout syndrome is a rare condition in which spontaneous, progressive resorption of bone occurs. The diagnosis is based on clinical, radiological and histopathological findings after excluding other etiologies and as a result it is often delayed. We present the case of a 21-year-old male diagnosed with Gorham-Stout syndrome with involvement of the majority of the mandible, partial involvement of right maxillary, temporal and zygomatic bones and discuss its diagnostic and therapeutic features.

Fatal Progression of Gorham Disease: A Case Report and Review of the Literature

Gorham disease is an idiopathic massive osteolysis, and maxillofacial involvement is rare. This report describes a case of a 12-year-old boy with severe progressive osteolysis in the mandible, hyoid bone, mastoid process, and cervical spine. Radiation therapy and interferon-α therapy were followed by bisphosphonate therapy. The patient died of respiratory failure. To describe the clinicopathologic features of Gorham disease of the jaws with an emphasis on the fatal types, 64 cases in the literature were reviewed (female-to-male ratio, 1:1.78; average age, 33.02 ± 19.38 yr). Most lesions were located only in the mandible or in other locations in combination with the mandible, except for 3 cases. During follow-up, there were 7 cases of disease-specific death, resulting in a mortality rate of 10.94%. The main causes of death were chylothorax, rib fractures secondary to osteolysis, or spinal fractures. Although most patients received surgical treatment (43.75%), the type of treatment was not related to prognosis.

"Vanishing Bone Disease" in Maxillofacial Region: A Review and Our Experience

Vanishing bone disease (VBD) is a rare disease of unknown etiology which is characterised by progressive replacement of bony framework by proliferation of endothelial lined lymphatic vessels. It has been given numerous names like massive osteolysis, Gorham's disease, phantom bone disease, and progressive osteolysis. It has no age, sex or race predilection. It may involve single or multiple bones and spread of the disease does not respect the relevant joint as boundary. The first report of the disease was published around two decades back but the mysterious nature of its etiology and ideal management strategy has still not been completely unfolded. The disease may functionally or aesthetically effect the patient and also has the potential to be life threatening. The first case of VBD in maxillofacial region was reported by Romer in 1924, Handbuch der speziellen pathologischen Anatomie and histology, Springer, Berlin. Since then, there have been few case reports of the same in maxillofacial region. We present a review of cases of VBD in maxillofacial region reported in literature along with our experience of a case.

Unspecific, idiopathic isolated osteolysis (Gorham-Stout syndrome) of the mandibular condylar process with its radiological, histological and clinical features: a case report and review of literature

BACKGROUND

The unspecific, idiopathic isolated osteolysis is a rare condition in the various known osteopathies and better known as Gorham-Stout syndrome (Gorham's disease, GD). It belongs to the primary idiopathic osteolysis, and its aetiology is poorly understood. Many different localisations have been described, but there are only 48 cases affecting the maxillofacial region until now.

CASE REPORT

A 76-year-old patient with the singular localisation of GD in the left condylar process is presented. After radical resection of the condylar process, the clinical, radiological and pathological examinations made the diagnosis of GD. Until now, there is no recurrence for two and a half years.

DISCUSSION

The unspecific and inconsistent clinical and radiological symptoms complicate the diagnosis of GD. Clinical, pathological and radiological correlation is essential to make the diagnosis. The different therapeutical options and the specific outcome are discussed.