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Orthopaedics · Bone tumours: Gorham-Stout disease
Sample itemA 20-year-old has progressive painless disappearance of the humerus and scapula over two years. Radiographs show tapering of bone with no new bone formation and no soft tissue mass, and biopsy shows proliferating thin-walled vascular channels. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Gorham-Stout disease
Gorham-Stout disease, or vanishing bone disease, is a non-neoplastic condition of massive osteolysis with replacement by angiomatous or lymphatic tissue. There is no osteoblastic response and the bone seems to dissolve. Chylothorax can complicate involvement of the ribs or spine.
Option by option
A. Gorham-Stout disease (correct)
Correct. Painless osteolysis with vascular proliferation and no bone reaction is Gorham-Stout disease.
B. Paget disease of bone
Paget disease shows sclerosis, bone enlargement and coarse trabeculae, not disappearance of bone.
C. Eosinophilic granuloma
Eosinophilic granuloma is a localised lytic lesion in a child with Langerhans cells on biopsy.
D. Multiple myeloma
Myeloma produces punched-out lytic lesions with an abnormal paraprotein and marrow plasma cells.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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