title: Gorham-Stout syndrome in mainland China: a case series of 67 patients and review of the literature.
abstract: OBJECTIVE
  Gorham-Stout syndrome (GSS) is a rare disorder of uncertain etiology and unpredictable prognosis. This study aims to present a comprehensive understanding of this rare entity.
  
  
  METHODS
  A literature search in PubMed and three Chinese databases was performed to screen histologically proven GSS cases among Chinese residents in the mainland. We analyzed the patients' clinical characteristics, the value of different treatment modalities and their influence on the clinical outcome.
  
  
  RESULTS
  Sixty-seven cases were finally enrolled. There were 43 men (64.2%) and 24 women (35.8%). The mean age at diagnosis was 28 years (1.5-71 years). The most common clinical symptoms included pain (n=40, 59.7%), functional impairment (n=13, 19.4%), and swelling (n=12, 17.9%). The radiographic presentation of 37 cases (55.2%) was disappearance of a portion of the bone. The others presented as radiolucent foci in the intramedullary or subcortical regions. A total of 42 cases provided data on therapy, these included surgery (n=27, 40.3%), radiation therapy (n=6, 9.0%), surgery combined with radiation therapy (n=2, 3.0%), and medicine therapy (n=7, 10.4%). For 30 of these 42 cases, follow-up data were available: 21 cases had the disorder locally controlled and 9 had a symptom progression. Fortunately, the disease is not fatal in the majority of cases.
  
  
  CONCLUSIONS
  GSS has no specific symptoms and it should be taken into consideration when an unclear massive osteolysis occurs. The efficacies of different treatment modalities are still unpredictable and further research is required to assess the values of different treatments.
authors.affiliation: Cardiovascular Key Lab of Zhejiang Province, Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China. hu999po@126.com
authors.forename: Po
authors.initials: P
authors.lastname: Hu
authors.forename: Xiang-gui
authors.initials: XG
authors.lastname: Yuan
authors.forename: Xin-yang
authors.initials: XY
authors.lastname: Hu
authors.forename: Fa-rong
authors.initials: FR
authors.lastname: Shen
authors.forename: Jian-an
authors.initials: JA
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010015:Osteolysis, Essential / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
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