Gorham disease

Gorham 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 may spread to involve adjacent bony and soft tissue structures.

Other names for this condition include progressive massive osteolysisGorham-Stout disease, and phantom bone disease.

Gorham disease is thought to be non-hereditary and there is no recognized gender predilection. It can potentially occur in any age group although most reported cases have been in young adults 2.

Signs and symptoms are incredibly varied depending on the bones involved, and may only become apparent after a fracture.

The osteolysis is thought to be due to an increased number of stimulated osteoclasts 3, which is likely secondary to abundant non-neoplastic vascular and lymphatic proliferation in the affected region 9. The bone is subsequently replaced by variable amounts of fibrous connective tissue that is hypervascular10.

Gorham disease can potentially involve any bone. Reported sites include:

  • humerus (first reported case)
  • shoulder girdle
  • pelvis
  • skull 2
  • mandible

Splenic lesions (cysts) and soft-tissue involvement underlying skeletal disease represent characteristic extraskeletal manifestations supporting the diagnosis 6.

  • intramedullary or subcortical lucent foci may be the earliest manifestation 1
  • this progresses to profound osteolysis with resorption of affected bone and lack of compensatory osteoblastic activity or periosteal reaction
  • 99mTc bone scan may initially be positive but later becomes negative with ongoing bone resorption

It was first reported by Jackson in 1838 12 and later defined by Gorham and Stout in 1955 13.

Imaging differential considerations include:

Bone tumours

The differential diagnosis for bone tumors is dependent on the age of the patient, with a very different set of differentials for the pediatric patient.

Article information

rID: 7998
Synonyms or Alternate Spellings:
  • Vanishing bone disease
  • Massive osteolysis of Gorham
  • Dissapearing bone disease
  • Disappearing bone disease
  • Gorham-Stout disease
  • Phantom bone disease
  • Progressive massive osteolysis
  • Gorham's disease

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Cases and figures

  • Case 1: involving scapula and clavicle
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  • Case 2: mandible
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  • Case 3: feet
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