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Clinical Rheumatology

, Volume 35, Issue 3, pp 813–823 | Cite as

Gorham-Stout disease: radiological, histological, and clinical features of 12 cases and review of literature

  • Yi Liu
  • Ding-Rong Zhong
  • Pei-Ran Zhou
  • Fang Lv
  • Dou-Dou Ma
  • Wei-Bo Xia
  • Yan Jiang
  • Ou Wang
  • Xiao-Ping Xing
  • Mei Li
Case Based Review

Abstract

Gorham-Stout disease (GSD) is an exceedingly rare disease characterized by progressive osteolysis and angiomatosis. We investigate the features of this disease and evaluate the effects of bisphosphonates (BPs) on it. The clinical, radiological, and pathological characteristics of 12 patients diagnosed with GSD were summarized. Immunohistochemical staining with specific lymphatic endothelial markers (D2-40), vascular markers (CD 31, CD 34), and vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor 3 (VEGFR-3) was performed in specimens of bone biopsy. Patients were treated with either BPs or conjunction therapy of radiation and BPs. The effects of BPs were evaluated by the change of radiological progression, bone mineral density (BMD) and bone turnover biomarkers. To further evaluate the prognosis, a literature review was done. Idiopathic massive osteolysis was found in all patients, including 11 polyostotic and one mono-ostotic osteolysis. Soft tissue lymphangioma was presented in four patents. Four patients were complicated with chylothorax. Endothelial cells lining the proliferative vessels were positive for CD31 and CD34 and D2-40. Mild expression of VEGF and VEGFR-3 was also revealed. Stabilization in osteolysis and improvement in BMD were observed after single therapy with BPs or combined with radiotherapy. High mortality rate was found in patients with chylothorax. Spontaneous, progressive osteolysis is the most typical sign of GSD. BPs and radiotherapy can contribute to the clinical stabilization in bone lesion of GSD. The complicated chylothorax possibly indicates poor prognosis.

Keyword

Bisphosphonate Gorham-Stout disease Osteolysis Radiotherapy 

Notes

Acknowledgments

We thank the support of the National Natural Science Foundation of China (81100623).

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2014

Authors and Affiliations

  • Yi Liu
    • 1
  • Ding-Rong Zhong
    • 2
  • Pei-Ran Zhou
    • 1
  • Fang Lv
    • 1
  • Dou-Dou Ma
    • 1
  • Wei-Bo Xia
    • 1
  • Yan Jiang
    • 1
  • Ou Wang
    • 1
  • Xiao-Ping Xing
    • 1
  • Mei Li
    • 1
  1. 1.Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of HealthPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceBeijingChina
  2. 2.Department of PathologyPeking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical ScienceBeijingChina

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