Gorham's disease or vanishing bone disease is a poorly understood rare skeletal condition which manifests with massive progressive osteolysis along with a proliferation of thin walled vascular channels.
The disease starts in one bone but can spread to adjacent bony and soft tissues.
It is thought to be non hereditary and there is no recognised gender predilection. Can potentially occur in any age group although most reported cases have been in young adults 2.
Can potentially involve any bone. Reported sites include
- humerus (first reported case)
- shoulder girdle
- skull 2
Splenic lesions and soft-tissue involvement can be common extra skeletal manifestations 6.
The osteolysis is thought to be due an increased number of stimulated osteoclasts3, which is likely secondary to benign vascular proliferation in the affected region9.
Plain film and CT
- intramedullary or subcortical lucent foci may be the earliest manifestation1.
- this progresses to profound osteolysis with resorption of affected bone and lack of compensatory osteoblastic activity or periosteal reaction.
- Tc99m bone scan may be initially positive but later becomes negative with ongoing bone resorption.
It was first reported by Jackson in 1838 but later defined by Gorham and Stout in 1955
Imaging differential considerations include
- 1- Collins J. Case 92: Gorham syndrome. Radiology. 2006;238 (3): 1066-9. Radiology (full text) - doi:10.1148/radiol.2383032126 - Pubmed citation
- 2- Lo CP, Chen CY, Chin SC et-al. Disappearing calvarium in Gorham disease: MR imaging characteristics with pathologic correlation. AJNR Am J Neuroradiol. 2004;25 (3): 415-8. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 3- Möller G, Priemel M, Amling M et-al. The Gorham-Stout syndrome (Gorham's massive osteolysis). A report of six cases with histopathological findings. J Bone Joint Surg Br. 2000;81 (3): 501-6. Pubmed citation
- 4- Glass-Royal M, Stull MA. Musculoskeletal case of the day. Gorham syndrome of the right clavicle and scapula. AJR Am J Roentgenol. 1990;154 (6): 1335-6. doi:10.2214/ajr.154.6.2110757 - Pubmed citation
- 5- Okafuji T, Yabuuchi H, Soeda H et-al. Gorham's disease of the chest wall: CT and MR characteristics. J Thorac Imaging. 2006;20 (4): 284-7. Pubmed citation
- 6- Kotecha R, Mascarenhas L, Jackson HA et-al. Radiological features of Gorham's disease. Clin Radiol. 2012;67 (8): 782-8. doi:10.1016/j.crad.2012.01.009 - Pubmed citation
- 7- Spieth ME, Greenspan A, Forrester DM et-al. Gorham's disease of the radius: radiographic, scintigraphic, and MRI findings with pathologic correlation. A case report and review of the literature. Skeletal Radiol. 1998;26 (11): 659-63. Pubmed citation
- 8- Damron TA, Brodke DS, Heiner JP et-al. Case report 803: Gorham's disease (Gorham-Stout syndrome) of scapula. Skeletal Radiol. 1994;22 (6): 464-7. Pubmed citation
- 9. Rauh G, Gross M. Disappearing bone disease (Gorham-stout disease): report of a case with a follow-up of 48 years. Eur. J. Med. Res. 1998;2 (10): 425-7. Pubmed citation
Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Vanishing bone disease||✗|
|Dissapearing bone disease||✗|
|Disappearing bone disease||✗|