Skeletal Radiology

, Volume 40, Issue 11, pp 1391–1397 | Cite as

Gorham–Stout disease: the experience of the Rizzoli Institute and review of the literature

  • Pietro RuggieriEmail author
  • Maurizio Montalti
  • Andrea Angelini
  • Marco Alberghini
  • Mario Mercuri
Review Article


Gorham–Stout disease (also known as “disappearing bone disease”) was first described by Jackson in 1838, but was properly defined by Gorham and Stout in a series of 24 patients in 1954–1955. It is a rare disease of unknown etiology (about 200 cases reported in the literature) characterized by spontaneous progressive resorption of bone without malignant proliferation of vascular structures. The diagnosis is one of exclusion and it is based on combined histological, radiological, and clinical features. Benign vascular proliferation with fatty bone marrow and thinning of bony trabeculae is a typical histological feature. Standard radiographs of disappearing bone disease show progressive bony resorption with adjacent soft tissue involvement. Most cases of Gorham–Stout disease resolve spontaneously, but prognosis remains unpredictable. This study reports 13 cases of Gorham–Stout disease treated in our institution from 1968 to 2008. The aim of the work was to review our series and the literature on this rare disease, as well as to evaluate whether or not an optimal treatment can be identified and recommended.


Gorham–Stout disease Massive osteolysis Vanishing bone disease Hemangiomatosis MRI 


Conflict of interest

The authors declare that there is no conflict of interest.


  1. 1.
    Jackson JBS. A boneless arm. Boston Med Surg J. 1838;18:368–9.Google Scholar
  2. 2.
    Gorham LW, Stout AP. Massive osteolysis (acute spontaneous absorption of bone, phantom bone, disappearing bone): its relation to hemangiomatosis. J Bone Joint Surg Am. 1955;37(5):985–1004.PubMedGoogle Scholar
  3. 3.
    Moller 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. 1999;81-B:501–6.CrossRefGoogle Scholar
  4. 4.
    Gorham LW, Wright AW, Shultz HH, et al. Disappearing bones: a rare form of massive osteolysis: report of two cases, one with autopsy findings. Am J Med. 1954;17:674–82.PubMedCrossRefGoogle Scholar
  5. 5.
    Florchinger A, Bottger E, Claass-Bottger F, Georgi M, Harms J. Gorham-Stout syndrome of the spine. Case report and review of the literature. Rofo. 1998;168:68–76.PubMedCrossRefGoogle Scholar
  6. 6.
    Tsang WM, Tong AC, Chow LT, Ng IO. Massive osteolysis (Gorham disease) of the maxillofacial skeleton: report of 2 cases. J Oral Maxillofac Surg. 2004;62(2):225–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Hardegger F, Simpson LA, Segmueller G. The syndrome of idiopathic osteolysis. Classification, review, and case report. J Bone Joint Surg Br. 1985;67-B:89–93.Google Scholar
  8. 8.
    Milner SM, Baker SL. Disappearing bones. J Bone Joint Surg Br. 1958;40(2):502–13.PubMedGoogle Scholar
  9. 9.
    Branch HE. Acute spontaneous absorption of bone: report of a case involving a clavicle and a scapula. J Bone Joint Surg. 1945;27(3):706–10.Google Scholar
  10. 10.
    Patel DV. Gorham’s disease or massive osteolysis. Clin Med Res. 2005;3(2):65–74.PubMedCrossRefGoogle Scholar
  11. 11.
    Moller G, Gruber H, Priemel M, Werner M, Kuhlmey AS, Delling G. Gorham-Stout idiopathic osteolysis: local osteoclastic hyperactivity? Pathologe. 1999;20:177–82.PubMedCrossRefGoogle Scholar
  12. 12.
    Manisali M, Ozaksoy D. Gorham disease: correlation of MR findings with histopathologic changes. Eur Radiol. 1998;8:1647–50.PubMedCrossRefGoogle Scholar
  13. 13.
    Heyden G, Kindblom L-G, Nielsen JM. Disappearing bone disease: a clinical and histological study. J Bone Joint Surg Am. 1977;59-A:57–61.Google Scholar
  14. 14.
    Young JW, Galbraith M, Cunningham J, et al. Progressive vertebral collapse in diffuse angiomatosis. Metab Bone Dis Relat Res. 1983;5:53–60.PubMedCrossRefGoogle Scholar
  15. 15.
    Hirayama T, Sabokbar A, Itonaga I, Watt-Smith S, Athanasou NA. Cellular and humoral mechanisms of osteoclast formation and bone resorption in Gorham-Stout disease. J Pathol. 2001;195:624–30.PubMedCrossRefGoogle Scholar
  16. 16.
    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. 1997;26:659–63.PubMedCrossRefGoogle Scholar
  17. 17.
    Drewry GR, Sutterlin III CE, Martinez CR, et al. Gorham disease of the spine. Spine. 1994;19:2213–22.PubMedCrossRefGoogle Scholar
  18. 18.
    Fisher KL, Pogrel MA. Gorham’s syndrome (massive osteolysis): a case report. J Oral Maxillofac Surg. 1990;48:1222–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Chung C, Yu JS, Resnick D, et al. Gorham syndrome of the thorax and cervical spine: CT and MRI findings. Skeletal Radiol. 1997;26:55–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Vinee P, Tanyu MO, Hauenstein KH, et al. CT and MRI of Gorham syndrome. J Comput Assist Tomogr. 1994;18:985–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Yoo SY, Hong SH, Chung HW, Choi JA, Kim CJ, Kang HS. MRI of Gorham’s disease: findings in two cases. Skeletal Radiol. 2002;31:301–6.PubMedCrossRefGoogle Scholar
  22. 22.
    Bode-Lesniewska B, Von Hochstetter A, Exner GU, Hodler J. Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine: fatal course in a 65-year-old woman. Skeletal Radiol. 2002;31:724–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Wenger DE, Wold LE. Benign vascular lesions of bone: radiologic and pathologic features. Skeletal Radiol. 2000;29:63–74.PubMedCrossRefGoogle Scholar
  24. 24.
    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. 1997;2(10):425–7.PubMedGoogle Scholar
  25. 25.
    Mendez AA, Keret D, Robertson W, et al. Massive osteolysis of a femur (Gorham’s disease): a case report and review of the literature. J Pediatr Orthoped. 1989;9:604–8.CrossRefGoogle Scholar
  26. 26.
    Shives TC, Beabout JW, Unni KK. Massive osteolysis. Clin Orthop Relat Res. 1993;294:267–76.PubMedGoogle Scholar
  27. 27.
    Dunbar SF, Rosenberg A, Mankin H, et al. Gorham’s massive osteolysis: the role of radiation therapy and a review of the literature. Int J Radiat Oncol Biol Phys. 1993;26:491–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Livesley PJ, Saifuddin A, Webb PJ, Mitchell N, Ramani P. Gorham’s disease of the spine. Skeletal Radiol. 1996;25:403–5.PubMedCrossRefGoogle Scholar
  29. 29.
    Hammer F, Kenn W, Wesselmann U, et al. Gorham-Stout disease-stabilization during bisphosphonate treatment. J Bone Miner Res. 2005;20:350–3.PubMedCrossRefGoogle Scholar
  30. 30.
    Hagberg H, Lamberg K, Aström G. Alpha-2b interferon and oral clodronate for Gorham’s disease. Lancet. 1997;350:1822–3.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2010

Authors and Affiliations

  • Pietro Ruggieri
    • 1
    Email author
  • Maurizio Montalti
    • 1
  • Andrea Angelini
    • 1
  • Marco Alberghini
    • 2
  • Mario Mercuri
    • 1
  1. 1.Department of OrthopedicsUniversity of Bologna, Istituto Ortopedico RizzoliBolognaItalia
  2. 2.Anatomy and Pathological Histology UnitIstituto Ortopedico RizzoliBolognaItalia

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