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Zhang L, Li J, Yao F, Chen Y, Zhang S, Lv H, Jing J. Treatment of gorham-stout disease with bisphosphonates and total hip arthroplasty: A case report. Front Surg 2023; 10:1078869. [PMID: 36793315 PMCID: PMC9922857 DOI: 10.3389/fsurg.2023.1078869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023] Open
Abstract
Background Gorham-Stout disease (GSD) is a rare osteolytic disease with unknown etiology, varied clinical manifestations and unpredictable prognosis. This disease is characterized by progressive massive local osteolysis and resorption caused by intraosseous lymphatic vessel structure and thin-walled vascular proliferation. The diagnosis of GSD has not yet formed a uniform standard, but the combination of clinical manifestations, radiological features and unique histopathological examinations and excluding other diseases contribute to early diagnosis. Although medical therapy, radiotherapy and surgical interventions or combinations have been used for the treatment of GSD, there is currently still no recommended standardized treatment regimen. Case report This paper presents a case of a previously healthy 70-year-old man presented with a 10-year history of severe right hip pain and progressive walking disorder of the lower limbs. Based on the patient's clear clinical presentation, unique radiological features, and histological findings, a diagnosis of GSD was made with the exclusion of other potential diseases. The patient was treated with bisphosphonates to slow the progression of the disease followed by total hip arthroplasty to help restore walking function. At the 3-year follow-up, the patient returned to normal walking and no recurrence was observed. Conclusion Bisphosphonates combined with total hip arthroplasty may be an effective method for the treatment of severe GSD in the hip joint.
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Affiliation(s)
- LiQian Zhang
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - JianJian Li
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - Fei Yao
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - YiHao Chen
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - Shuo Zhang
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - Hao Lv
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Correspondence: Hao Lv JueHua Jing
| | - JueHua Jing
- Department of Orthopaedics & Joint Reconstruction Surgery, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Institute of Orthopaedics, Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Anhui Medical University, Hefei, China,Correspondence: Hao Lv JueHua Jing
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Yébenes Mayordomo M, Al Shboul S, Gómez-Herranz M, Azfer A, Meynert A, Salter D, Hayward L, Oniscu A, Patton JT, Hupp T, Arends MJ, Alfaro JA. Gorham-Stout case report: a multi-omic analysis reveals recurrent fusions as new potential drivers of the disease. BMC Med Genomics 2022; 15:128. [PMID: 35668402 PMCID: PMC9169400 DOI: 10.1186/s12920-022-01277-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/23/2022] [Indexed: 12/31/2022] Open
Abstract
Background Gorham-Stout disease is a rare condition characterized by vascular proliferation and the massive destruction of bone tissue. With less than 400 cases in the literature of Gorham-Stout syndrome, we performed a unique study combining whole-genome sequencing and RNA-Seq to probe the genomic features and differentially expressed pathways of a presented case, revealing new possible drivers and biomarkers of the disease. Case presentation We present a case report of a white 45-year-old female patient with marked bone loss of the left humerus associated with vascular proliferation, diagnosed with Gorham-Stout disease. The analysis of whole-genome sequencing showed a dominance of large structural DNA rearrangements. Particularly, rearrangements in chromosomes seven, twelve, and twenty could contribute to the development of the disease, especially a gene fusion involving ATG101 that could affect macroautophagy. The study of RNA-sequencing data from the patient uncovered the PI3K/AKT/mTOR pathway as the most affected signaling cascade in the Gorham-Stout lesional tissue. Furthermore, M2 macrophage infiltration was detected using immunohistochemical staining and confirmed by deconvolution of the RNA-seq expression data.
Conclusions The way that DNA and RNA aberrations lead to Gorham-Stout disease is poorly understood due to the limited number of studies focusing on this rare disease. Our study provides the first glimpse into this facet of the disease, exposing new possible therapeutic targets and facilitating the clinicopathological diagnosis of Gorham-Stout disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-022-01277-x.
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Affiliation(s)
| | - Sofian Al Shboul
- Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Maria Gómez-Herranz
- International Center for Cancer Vaccine Science (ICCVS), University of Gdansk, Gdańsk, Poland.,Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Asim Azfer
- Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Alison Meynert
- MRC Human Genetics Unit, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, Scotland
| | - Donald Salter
- Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Larry Hayward
- Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Anca Oniscu
- Department of Pathology, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| | - James T Patton
- Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland
| | - Ted Hupp
- Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Mark J Arends
- Edinburgh Pathology, Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, Scotland
| | - Javier Antonio Alfaro
- International Center for Cancer Vaccine Science (ICCVS), University of Gdansk, Gdańsk, Poland.
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Suzuki N, Cintra FF, Cintra ML, Maciel MG, Amstalden EMI, Teixeira F, Kubba F. "A case of vanishing bone disease complicated by chylothorax- diagnosis and treatment". JRSM Open 2022; 13:20542704221103912. [PMID: 35774987 PMCID: PMC9237928 DOI: 10.1177/20542704221103912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 16-year old girl with Gorham-Stout disease is presented. She had progressive replacement of the bones of her left arm and shoulder girdle by fibroadipose tissue and numerous proliferated, non-neoplastic, lymphatic channels. The clinico-pathologic features of this condition are discussed, as are its possible complications and available therapeutic modalities.
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Affiliation(s)
- N Suzuki
- Department of Dermatology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - FF Cintra
- Department of Orthopedics, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - ML Cintra
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - MG Maciel
- Department of Dermatology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - EMI Amstalden
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - F Teixeira
- Department of Pathology, Medical Sciences School, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - F Kubba
- Department of Pathology, London Northwest University Healthcare NHS Trust, UK
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Watanabe T, Yazama H, Kunimoto Y, Koyama S, Fujiwara K. A Case of Gorham-Stout Disease Treated with Fistula Closure by Transmeatal Approach. Yonago Acta Med 2021; 64:318-323. [PMID: 34434067 DOI: 10.33160/yam.2021.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 07/20/2021] [Indexed: 11/05/2022]
Abstract
Gorham-Stout disease, a rare and intractable disease of unknown etiology, causes systemic bone lysis and replacement with lymphoid tissue. Here, we report a case of Gorham-Stout disease with cerebrospinal fluid leakage in a 16-year-old boy. The patient complained of nasal discharge, right ear obstruction, fever, and headache. A computed tomography scan of the head showed osteolysis around the right internal carotid artery, vestibule, and cochlea and osteolytic changes in the left parietal bone. It was suggested that the patient had bacterial meningitis owing to the leakage of cerebrospinal fluid from the fistula caused by the temporal bone osteolysis. He was treated with meropenem, and a transmeatal fistula closure and a bone biopsy of the left parietal bone were performed. Intraoperatively, osteolysis was observed on the promontory and around the internal carotid artery. The fistula was closed by dense filling and compression around the fistula, in the middle ear cavity, and in the external auditory canal. The symptoms disappeared after the surgery. Bone biopsy showed the presence of a lymphangioma, and Gorham-Stout disease was diagnosed. Prophylactic bisphosphonate therapy was initiated. A 4-year follow-up revealed no progression of the disease.
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Affiliation(s)
- Tasuku Watanabe
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago
| | - Hiroaki Yazama
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago
| | | | - Satoshi Koyama
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago
| | - Kazunori Fujiwara
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago
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