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      Gorham–Stout disease with life-threatening pleural effusion treated with a pleuro-peritoneal shunt: a case report

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          Abstract

          Summary

          Gorham–Stout disease (GSD) is a rare bone disease characterized by massive osteolysis and lymphatic proliferation. The origin of the condition is unknown, and no established treatment protocol exists. Massive pleural effusion is a frequent complication of GSD in the thoracic region. We present the case of a 23-year-old male with thoracic GSD, subsequent paraparesis, and life-threatening pleural effusion. The patient was managed by a multidisciplinary team with a good recovery. The pleural effusion was successfully treated with a pleuro-peritoneal shunt. This is the first report of the use of this mini-invasive technique in the management of pleural effusion related to GSD. Further, we present the potential role of interleukin-6 and bone resorption markers in the measurement of the disease activity.

          Learning points
          • Multidisciplinary approach is important in the management of rare and severe disorders such as Gorham-Stout disease.

          • Pleuro-peritoneal shunting is a valuable option in the treatment of pleural effusion related to GSD.

          • Interleukin-6 and bone resorption markers appear useful in measuring the disease activity of GSD.

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          Most cited references13

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          Massive osteolysis (acute spontaneous absorption of bone, phantom bone, disappearing bone); its relation to hemangiomatosis.

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            Perspectives on massive osteolysis. Report of a case and review of the literature.

            Massive osteolysis is a rare, chronic disease characterized by the progressive dissolution of contiguous osseous structures. There is no regeneration following the osteolysis. Pathologic fracture often leads to its discovery. The etiology and pathophysiology of the disease remain obscure. Chemo- and radiotherapeutic attempts at arresting the osteolytic process are generally unsuccessful. Bone grafting has proved disappointing, as the graft usually undergoes osteolysis. A new case of facial bone involvement in a 13-year-old boy is presented. The literature is reviewed, and the clinical experience gained from treating the disease is discussed.
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              Vanishing bone disease (Gorham-Stout syndrome): A review of a rare entity.

              Vanishing bone disease (Gorham-Stout syndrome) is a rare entity of unknown etiology, characterized by destruction of osseous matrix and proliferation of vascular structures, resulting in destruction and absorption of bone. Despite the extensive investigation of the pathogenetic mechanisms of the disease, its etiology hasn't been clarified and several theories exist. The syndrome can affect one or multiple bones of the patient, including the skull, the upper and lower extremities, the spine and pelvis. The clinical presentation of a patient suffering from vanishing bone disease includes, pain, functional impairment and swelling of the affected region, although asymptomatic cases have been reported, as well as cases in which the diagnosis was made after a pathologic fracture. In this short review we summarize the theories regarding the etiology as well as the clinical presentation, the diagnostic approach and treatment options of this rare disease.

                Author and article information

                Journal
                Endocrinol Diabetes Metab Case Rep
                Endocrinol Diabetes Metab Case Rep
                EDM
                Endocrinology, Diabetes & Metabolism Case Reports
                Bioscientifica Ltd (Bristol )
                2052-0573
                03 May 2022
                2022
                : 2022
                : 21-0101
                Affiliations
                [1 ]Department of Orthopaedic and Trauma Surgery , Department of Internal Medicine
                [2 ]Department of Cardiothoracic Surgery , Department of Internal Medicine
                [3 ]Centre for Rheumatic Diseases , Department of Internal Medicine
                [4 ]Unit of Endocrinology , Department of Internal Medicine, Faculty of Medicine and Health Technology, Tampere University, Tampere University Hospital, Tampere, Finland
                Author notes
                Correspondence should be addressed to L A Toivonen; Email: leevi.toivonen@ 123456pshp.fi
                Author information
                http://orcid.org/0000-0003-1195-913X
                Article
                EDM210101
                10.1530/EDM-21-0101
                9175580
                35642669
                96f5dd19-5e38-4137-9fa6-bcee4fae6c5f
                © The authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License..

                History
                : 06 March 2022
                : 03 May 2022
                Categories
                Adolescent/Young Adult
                Male
                White
                Finland
                Bone
                Bone
                Surgery
                Novel Treatment
                Novel Treatment

                adolescent/young adult,male,white,finland,bone,surgery,novel treatment,june,2022

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