Gorham-Stout disease--stabilization during bisphosphonate treatment.
A 45-year-old woman presented with recent onset of left-sided chest pain. On clinical examination, these symptoms seemed to be strictly localized to a region that was marked by a long-standing cutaneous erythematous lesion. Laboratory results showed no gross abnormalities. Radiological imaging including conventional X-ray, MRI scans, and 3D CT reconstruction of the rib cage revealed circumscript destruction of the left lateral ribs 9-11. Histological analysis of a rib biopsy showed angiomatous hypervascularization and intracortical fibrosis. In keeping with these findings, the patient's condition was diagnosed as Gorham-Stout disease, a rare condition with localized, often unilateral, bone destruction. Monotherapy with bisphosphonates (pamidronate 30 mg i.v. every 3 months) was initiated, leading to rapid disappearance of local pain. Follow-up over 24 months documented a stable clinical and radiological picture without evidence of progressive bone destruction.
Hammer
Fabian
F
Department of Medicine, Endocrine and Diabetes Unit, University of Würzburg, Würzburg, Germany.
Kenn
Werner
W
Wesselmann
Ulrich
U
Hofbauer
Lorenz C
LC
Delling
Günter
G
Allolio
Bruno
B
Arlt
Wiebke
W
D001706:Biopsy; D001842:Bone and Bones / Q000098:blood supply* / Q000473:pathology; D004164:Diphosphonates / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010015:Osteolysis, Essential / Q000175:diagnosis* / Q000188:drug therapy*; D000077268:Pamidronate; D012272:Ribs / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014965:X-Rays
D004164:Diphosphonates; D000077268:Pamidronate