Volume 3 | Issue 2 | October 2022-March 2023 | page: 65-77 | Ajay Krishnan, Preethesh Agrawal, Vatsal Parmar, Vikrant Chauhan, Devanand Degulmadi, Shivanand Mayi, Ravi Ranjan, Shiv Kumar Bali, Prartham C Amin, Pranav R Charde, Preety A Krishnan, Mirant R Dave, Bharat R Dave
DOI: https://doi.org/10.13107/bbj.2022.v03i02.043
Authors: Ajay Krishnan [1], Preethesh Agrawal [1], Vatsal Parmar [1], Vikrant Chauhan [1], Devanand Degulmadi [1], Shivanand Mayi [1], Ravi Ranjan [1], Shiv Kumar Bali [1], Prartham C Amin [1], Pranav R Charde [1], Preety A Krishnan [2], Mirant R Dave [1], Bharat R Dave [1]
[1] Department of Spine Surgery, Stavya Spine Hospital & Research Institute, Mithakhali, Ellisbridge, Ahmedabad, Gujarat, India.
[2] Department of Radiology, Stavya Spine Hospital & Research Institute, Mithakhali, Ellisbridge, Ahmedabad, Gujarat, India.
Address of Correspondence
Dr. Ajay Krishnan,
Department of Spine Surgery, Stavya Spine Hospital & Research Institute, Mithakhali, Ellisbridge, Ahmedabad, Gujarat, India.
E-mail: drajaykrishnan@gmail.com
Abstract
Background: Vanishing bone disease / Gorham-Stout disease (GSD) is a condition that produces deformity and instability of bone. The fibro lympho-vascular tissue replaces the bone leading to massive osteolysis and its sequelae, but the exact cause is yet unknown. The disease involves the spine infrequently, but due to the proximity of the spinal cord it can seriously affect the patient. The aim of this study is to report as a review to contribute to the diagnosis, and treatment modalities in GSD affection of spine with the reported literature available from 1983 till March 2022.
Materials & Method: This metanalysis study is focused on GSD involving the spine. The search was done in two databases PubMed and Google scholar from 1983 up to March 2022. The Study selection was done to study the demographic pattern of GSD in spine and its outcome with conservative and surgical treatment and to determine the best suitable medical treatment for stopping disease progression and achieving remission.
Results: We retrieved 72 articles from Google scholar and PubMed out of which 5 articles were excluded (90 reported cases). Heffez criteria was followed for diagnosis in all these cases (n=86, 95.5%). 57 patients (64%) were operated and 33 patients (36%) were managed conservatively. Per-operative failure to achieve a fixation/reconstruction were reported in 2 (2.53%) cases. Number of surgeries till follow-up were average 1.70+ 1.23 (1-5) surgeries. The average follow-up of cases reported was 47.1+ 48.9 (3-240 months). Union was documented in 10 cases (3.4%). 9 of these cases needed additional bone graft/substitute. Bisphosphonates(n=40), sirolimus (n=5), interferon (n=17), radiotherapy (n= 31) and beta-blockers (n=4) were given in medications. 23 patients had remission. Death occurred in 17 patients (18.88%).
Conclusion: Surgery is needed frequently. Failure of fixations, achieving union and remission are daunting and ’off label” therapies are the dictum. Radiotherapy has been used more frequently with or without bisphosphonates. Though promising medical treatment are evolving and focus of treatment is directed towards anti-angiogenic, anti-osteolytic and anabolic therapy, but no standard treatment recommendations can be made out from existing literature.
Keywords: Vanishing bone disease, Gorham stout, Osteolysis, Spine, Deformity, Sirolimus, TNF
References
1. Dickson GR, Hamilton A, Hayes D, Carr KE, Davis R, Mollan RAB. An investigation of vanishing bone disease. Bone. 1990;11(3):205–210.
2. Gorham lw sa. Massive osteolysis (acute spontaneous absorption of bone, phantom bone, disappearing bone); its relation to hemangiomatosis. J Bone Jt Surg Am. 1995;37(5):985–1004.
3. Nikolaou VS, Chytas D, Korres D, Efstathopoulos N. Vanishing bone disease (gorham-stout syndrome): A review of a rare entity. World J Orthop. 2014;5(5):694–698.
4. Sekharappa V, Arockiaraj J, Amritanand R, Krishnan V, David KS, David SG. Gorham’s disease of spine. Asian Spine J. 2013;7(3):242–247.
5. Momanu A, Caba L, Gorduza NC, Arhire OE, Popa AD, Ianole V, et al. Gorham-stout disease with multiple bone involvement—challenging diagnosis of a rare disease and literature review. Med. 2021;57(7):1–11.
6. Dellinger MT, Garg N, Olsen BR. Viewpoints on vessels and vanishing bones in Gorham-Stout disease. Bone [Internet]. 2014;63:47–52.
7. Grönroos M, Palomäki A. Young adult with Gorham’s disease presenting in an emergency department: a case report. J Med Case Rep. 2021;15(1):1–4.
8. Du CZ, Li S, Xu L, Zhou QS, Zhu ZZ, Sun X, et al. Spinal Gorham-Stout syndrome: Radiological changes and spinal deformities. Quant Imaging Med Surg. 2019;9(4):565–578.
9. Patel DV. Gorham’s disease or massive osteolysis. Clin Med Res. 2005;3:65–74.
10. Avelar RL, Martins VB, Antunes AA, de Oliveira Neto PJ AE. Use of zoledronic acid in the treatment of Gorham’s disease. Int J Pediatr Otorhinolaryngol. 2010;74:319–22.
11. Koto K, Inui K, Itoi M, Itoh K. Gorham-Stout disease in the rib and thoracic spine with spinal injury treated with radiotherapy, zoledronic acid, vitamin D, and propranolol: A case report and literature review. Mol Clin Oncol. 2019;11(6):551–556.
12. Dominguez R, Washowich TL. Pediatric Radiology plain film , CT , and MRI findings of two cases. 1994;316–318.
13. Tateda S, Aizawa T, Hashimoto K, Kanno H, Ohtsu S, Itoi E, et al. Successful management of gorham-stout disease in the cervical spine by combined conservative and surgical treatments: A case report. Tohoku J Exp Med. 2017;241(4):249–254.
14. Tilling G SB. Disappearing bone disease, Morbus Gorham: report of a case. Acta Orthop Scand. 1968;39:398–406.
15. Ali Akbar Esmailiejah, Naser Kamalian MA. Temporary Paraplegia resulting from Groham’s disease involving the third lumbar vertebrae and proximal femur: A five year Follow-up and review of the literarture. Arch Iran Med. 2013;16(11):686–690.
16. Paley MD, Lloyd CJ PC. Total mandibular reconstruction for massive osteolysis of the mandible. Br J Oral Maxillofac Surg. 2005;43:166–168.
17. Vinée P, Tanyü MO, Hauenstein KH, Sigmund G, Stöver B AC. CT and MRI of Gorham syndrome. J Comput Assist Tomogr. 1994;18:985–989.
18. Yoo SY, Hong SW. Chung HW, Choi JA, Kim CJ KH. MRI of the Gorham’s disease: finding in two cases. Skelet Radiol. 2002;31:301–306.
19. Heffez L, Feeney JE, Carter BL. Perspectives on massive osteolysis: report of a case and review of the literature. Oral Surgery, Oral Med Oral Pathol. 1993;55(4):331–343.
20. Ruggieri P, Montalti M, Angelini A, Alberghini M, Mercuri M. Gorham-Stout disease: The experience of the Rizzoli Institute and review of the literature. Skeletal Radiol. 2011;40(11):1391–1397.
21. Chang-Zhi Du, Song Li, Liang Xu, Qing-Shuang Zhou, Ze-Zhang Zhu, Xu Sun YQ. Spinal Gorham-Stout syndrome: radiological changes and spinal deformities. Quant Imaging Med Surg. 2019;9(4):565–578.
22. Ibrahim Saeed Gataa, Noroz Hama R. Nader Y, Abdallah DT. Massive Craniofacial Gorham Disease Treated Successfully by Cisplatin and 5-Fluorouracil With Ten Years of Follow-Up: A Case Report and Literature Review. J Oral Maxillofac Surg. 2016;74(9):1774–1782.
23. DevlinRD, BoneHG3rd R. Interleukin-6: a potential mediator of the massive osteolysis in patients withGorham– Stout disease. J Clin EndocrinolMetab. 1996;81:1893–1897.
24. Colucci S, Taraboletti G, Primo L, Viale A, Roca C, Valdembri D, Geuna M, Pagano M, Grano M, Pogrel AM et al. Gorham‑Stout syndrome: A monocyte‑mediated cytokine propelled disease. J Bone Min Res. 2006;21:207–18.
25. Dupond J-L, Bermont L, Runge M de BM. Plasma VEGF determination in disseminated lymphangiomatosis-Gorham– Stout syndrome. A marker of activity? A case report with a 5 years follow-up. Bone. 2010;46:873–876.
26. Kulenkampff HA, Richter GM, Hasse WE et al. Massive pelvic osteolysis in the Gorham-Stout syndrome. Int Orthop. 1990;14:361–366.
27. Cannon SR. Massive osteolysis. A review of seven cases. J Bone Jt Surg – Ser B. 1986;68(1):24–28.
28. Hardegger F, Simpson LA SG. The syndrome of idiopathic osteolysis. Classification, review, and case report. J Bone Jt Surg Br. 1985;67:88–93.
29. Lee BB, Rockson SG BJ. Lymphedema: a concise compendium of theory and practice. Springer. 2018;
30. P.J. L, Saifuddin A, Webb PJ, Mitchell N, Ramani P. Gorham’s disease of the spine. Skeletal Radiol. 1996;25:403–405.
31. Liu S, Zhou X, Song A, Kong X, Wang Y, Liu Y. Successful treatment of Gorham-Stout syndrome in the spine by vertebroplasty with cement augmentation: A case report and literature review. Med (United States). 2018;97(29):1–6.
32. Kahn HJ, Bailey D MA. Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi’s sarcoma and a subset of angiosarcomas. Mod Pathol. 2002;15(4):434–440.
33. Krishnan A, Raj A, Degulmadi D, Mayi S, Rai R, Bali SK, et al. Gorham-Stout disease: A multirod lumbar reconstruction with off-label suppression-remission therapy. Surg Neurol Int. 2022;13(136):1–5.
34. Bouloux GF, Walker DM MG. Massive osteolysis of the mandible: Report of a case with multifocal bone loss. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(3):357–361.
35. Sharma A, Iyer N, Mittal A, Das D SS. Vanishing mandible. J Oral Sci. 2012;52(3):513–516.
36. Tong A, Leung T, Surgery PC. Management of massive osteolysis of the mandible: a case report. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;109(2):238–41.
37. Gondivkar SM GA. Gorham-Stout syndrome: a rare clinical entity and review of literature. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2010;109(2):41–48.
38. Brodszki N, Länsberg JK, Dictor M, Gyllstedt E, Ewers SB, Larsson MK, et al. A novel treatment approach for paediatric Gorham-Stout syndrome with chylothorax. Acta Paediatr Int J Paediatr. 2011;100(11):1448–1453.
39. Tena-Sanabria ME, Jesús-Mejenes LY, Fuentes-Herrera G, Álvarez-Martínez FA, Victorio-García NP, Núñez-Enríquez JC. A report of two children with Gorham-Stout disease. BMC Pediatr. 2019;19(1):1–7.
40. Vanhoenacker FM, De Vuyst D, Vandervliet E, Veyt A, Vangeneugden J. Paget’s disease with vanishing bone pattern and spinal fusion. J Belge Radiol. 2007;90(5):388–390.
41. Damron TA, Brodke DS, Heiner JP, Swan JS DS. Gorham’s disease (Gorham-Stout syndrome) of scapula. Skelet Radiol. 1993;22:464–467.
42. Martín Noguerol T, Barousse R, Socolovsky M LA. A. Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries. Quant Imaging Med Surg. 2017;7:398–421.
43. Mawk JR, Obukhov SK, Nichols WD, Wynne TD, Odell JM, Urman SM. Successful conservative management of Gorham disease of the skull base and cervical spine. Child’s Nerv Syst. 1997;13:622–625.
44. Granado Peña JM, Báez Marrero O, Sosa Henríquez M. Gorham’s disease of the cervical spine. Case report. Neurocirugia. 1995;6(2):156–160.
45. Boyer, P.; Bourgeois, P.; Boyer, O.; Catonne, Y.; Saillant G. Massive Gorham-Stout syndrome of the pelvis. Clin Rheumatol. 2005;24:551–555.
46. Aizawa T, Sato T, Kokubun S. Gorham disease of the spine: A case report and treatment strategies for this enigmatic bone disease. Tohoku J Exp Med. 2005;205(2):187–196.
47. Kakuta Y, Iizuka H, Kobayashi R, Iizuka Y, Takahashi T, Mohara J, et al. Gorham disease of the lumbar spine with an abdominal aortic aneurysm: A case report. Spine J. 2014;14(1):5–9.
48. Chong Ng L, Sell P. Gorham disease of the cervical spine-a case report and review of the literature. Spine (Phila Pa 1976). 2003;28(18):355–358.
49. Barman A, Bhide R, Viswanathan A, George J, Thomas R, Tharion G. Gorham’s disease of the spine. NeuroRehabilitation. 2013;33(1):121–126.
50. Tie ML, Poland GA RE 3rd. Chylothorax in Gorham’s syndrome. A common complication of a rare disease. Chest. 1994;105(1):208–213.
51. Ellati R, Attili A, Haddad H, Al-Hussaini M SA. Novel approach of treating Gorham-Stout disease in the humerus: Case report and review of literature. Eur Rev Med Pharmacol Sci. 2016;20(3):426–432.
52. Mo AZ, Trenor CC, Hedequist DJ. Sirolimus Therapy as Perioperative Treatment of Gorham-Stout Disease in the Thoracic Spine A Case Report. JBJS Case Connect. 2018;8(3):1-7.
53. Manisali, M. & Ozaksoy D. Gorham disease: correlation of MR findings with histopathologic changes. Eur Radiol. 1998;8:1647–1650.
54. William H. Edwards, Roby c.thompson E varsa. Lymphangiomatosis and massive osteolysis of the cervical spine. Clin Orthop Relat Res. 1983;222–9.
55. Dunbar SF, Rosenberg A, Mankin H, Rosenthal D, Suit HD. Gorham’s massive osteolysis: the role of radiation therapy and a review of the literature. International Journal of Radiation Oncology* Biology* Physics. 1993 Jun 15;26(3):491-497.
56. Drewry GR, Martinez CR, Brantley SG. Gorham disease of the spine. Spine (Phila Pa 1976). 1994;19(19):2213–22.
57. Foult H, Goupille P, Aesch B, Valat JP, Burdin P JM. Massive osteolysis of the cervical spine. A case report. Spine (Phila Pa 1976). 1995;20(14):1636–1639.
58. Hans Hagberg, Kristina Lamberg GÅ. a-2b interferon and oral clodronate for Gorham’s disease. Lancet. 1997;350:1822–1823.
59. Khosrovi H, Ortiz O, Kaufman HH, Schocket SS, Reddy GN, Simmons D. Massive osteolysis of the skull and upper cervical spine: Case report and review of the literature. J Neurosurg. 1997;87(5):773–780.
60. Bode-Lesniewska B, Hochstetter A von, Exner GU, Hodler J. Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine: fatal course in a 65-year-old woman. Skelet Radiol. 2002;31:724–729.
61. Duffy BM, Manon R, Patel RR, Welsh JS. A case of Gorham’s disease with chylothorax treated curatively with radiation therapy. Clin Med Res. 2005;3(2):83–86.
62. Takahashi A, Ogawa C, Kanazawa T, Watanabe H, Suzuki M, Suzuki N, et al. Remission induced by interferon alfa in a patient with massive osteolysis and extension of lymph-hemangiomatosis: A severe case of Gorham-Stout syndrome. J Pediatr Surg. 2005;40(3):47–50.
63. Girn HRS, Towns G, Chumas P, Holland P, Chakrabarty A. Gorham’s disease of skull base and cervical spine – Confusing picture in a two year old. Acta Neurochir (Wien). 2006;148(8):909–913.
64. B. Kai, A. Ryan, P.L. Munk PD. Gorham disease of bone: three cases and review of radiological features. Clin Radiol. 2006;61:1058–1064.
65. Lekovic GP, Mariwalla NR, Horn EM, Chang S, Rekate HL, Theodore N. Skeletal dysplasia involving the subaxial cervical spine: Report of two cases and review of the literature. Neurosurgical focus. 2006 Feb 1;20(2):1-6.
66. Lehmann G, Pfeil A, Böttcher J, Kaiser WA, Füller J, Hein G, et al. Benefit of a 17-year long-term bisphosphonate therapy in a patient with Gorham-Stout syndrome. Arch Orthop Trauma Surg. 2009;129(7):967–972.
67. Kose M, Pekcan S, Dogru D, Akyuz C, Ozcelik U, Ozsurekci Y, et al. Gorham-Stout syndrome with chylothorax: Successful remission by interferon alpha-2b. Pediatr Pulmonol. 2009;44(6):613–615.
68. Sarah Mowry, MD; Rinaldo Canalis, MD F. Gorham-Stout Disease of the Temporal Bone. Laryngoscope. 2010;120:598–600.
69. Adler F, Gupta N, Hess CP, Dowd CF, Dillon WP. Intraosseous CSF fistula in a patient with Gorham disease resulting in intracranial hypotension. Am J Neuroradiol. 2011;32(11):198–200.
70. Deveci M, Nagihan İ, Çorapç F. Gorham-Stout Syndrome with Chylothorax in a Six-Year-Old Boy. 2011;78(June):737–739.
71. Heyd R, Micke O, Surholt C, Berger B, Martini C, Füller J, Schimpke T, Seegenschmiedt MH, German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD. Radiation therapy for Gorham-Stout syndrome: results of a national patterns-of-care study and literature review. International Journal of Radiation Oncology* Biology* Physics. 2011 Nov 1;81(3):179-185.
72. Rajendra Kumar Sahoo, Balavenkatasubramanian Jagannathan G, Palanichamy VN. Anaesthetic consideration in patients with Gorham ’ s syndrome : A case report and review of the literature. 2012;56(4):391–394.
73. Noda M, Endo C, Hoshikawa Y, Ishibashi N, Suzuki T, Okada Y, et al. Successful management of intractable chylothorax in Gorham-Stout disease by awake thoracoscopic surgery. Gen Thorac Cardiovasc Surg. 2013;61(6):356–358.
74. Zheng MW, Yang M, Qiu JX, Nan XP, Huang LY, Zhang WD, Gong L, Huang ZZ. Gorham-Stout syndrome presenting in a 5-year-old girl with a successful bisphosphonate therapeutic effect. Experimental and Therapeutic Medicine. 2012 Sep 1;4(3):449-451.
75. Kilicoglu ZG, Kis NK, Aker FV, Berkman MZ, Simsek MM. Gorham disease of the craniocervical junction: X-ray, computed tomography, and magnetic resonance imaging findings. The Spine Journal. 2013 May 1;13(5):11-14..
76. Maillot C, Cloche T, Le Huec JC. Thoracic osteotomy for Gorham-Stout disease of the spine: a case report and literature review. European Spine Journal. 2014;27(9):2285-2290.
77. Molina EJ, Niederstadt T, Ruland V, Kayser G, Stummer W, Ewelt C, Rössler J. Cerebrospinal fluid leakage in Gorham-Stout disease due to dura mater involvement after progression of an osteolytic lesion in the thoracic spine: Case report. Journal of Neurosurgery: Spine. 2014 Dec 1;21(6):956-960.
78. Vered Nir, MD, , Ludmila Guralnik, MD, Galit Livnat, MD, Ronen Bar-Yoseph M, Fahed Hakim, MD, Anat Ilivitzki, MD, and Lea Bentur M. Propranolol as a Treatment Option in Gorham–Stout Syndrome: A Case Report. Pediatr Pulmonol. 2014;49:417–419.
79. Kohno M, Aota Y, Kawai T, Murata H, Saito T. Surgical Treatment of Gorham’s Disease with Massive Osteolysis of the Skull and Cervical Spine: A Case Report and Review of Literature. NMC Case Rep J. 2015;2(2):80–84.
80. Ganal-Antonio AK, Samartzis D, Bow C, Cheung KM, Luk KD, Wong YW. Disappearing bone disease of the humerus and the cervico-thoracic spine: a case report with 42-year follow-up. The Spine Journal. 2016 Feb 1;16(2):67-75.
81. Carbó E, Riquelme Ó, García A, González JL. Vertebroplasty in a 10-year-old boy with Gorham–Stout syndrome. Eur Spine J. 2015;24:590–593.
82. Kim MK, Hong JR, Kim SG, Lee SK. Fatal Progression of Gorham Disease: A Case Report and Review of the Literature. J Oral Maxillofac Surg. 2015;73(12):2352–2360.
83. Pn G, Ac D, An P. A Rare Case of Progressive Gorham’s Disease of Right Shoulder Girdle and Cervical Spine in A Child: 10 Year Follow-up and A Review of Literature. J Orthop case reports. 2015;5(4):30–33.
84. Rössler J, Saueressig U, Kayser G, Von Winterfeld M, Klement GL. Personalized therapy for generalized lymphatic anomaly/gorham-stout disease with a combination of sunitinib and taxol. J Pediatr Hematol Oncol. 2015;37(8):481–485.
85. Adam Schell, John M. Rhee, Abigail Allen, Lindsay Andras FZ. Surgical management of gorham disease involving the upper cervical spine with occipito-cervical-thoracic fusion: a case report. Spine J. 2016;1–11.
86. Srivastava SK, Aggarwal RA, Nemade PS, Bhoale SK. Vanishing bone disease of chest wall and spine with kyphoscoliosis and neurological deficit: A case report and review of literature. Indian J Orthop. 2017;51(1):107–114.
87. Alexandre Jaccard, César Macedo, Gabriel Castro AG. Thoracic spine dislocation in Gorham–Stout Syndrome: Case report and literature review. Surg Neurol Int. 2018;9(223):1–3.
88. Wang P, Liao W, Cao G, Jiang Y. A rare case of Gorham-stout syndrome involving the thoracic spine with progressive bilateral chylothorax: A case report. BMC Musculoskelet Disord. 2019;20(1):1–6.
89. Jung Hwa Kim, MD, Do Heum Yoon, MD. PhD, Keung Nyun Kim, MD. PhD DA, Shin, MD. PhD, Seong Yi, MD. PhD, Jiin Kang, MD, Yoon Ha MP. Surgical management of Gorham-Stout disease in cervical compression fracture with cervico-thoracic fusion: A Case report and review of literature. World Neurosurg. 2019;129:277–281.
90. Barbagli G, Barni I, Romoli S. A rare case of spine disappearing bone disease: Lesson learned and review of the literature. Interdisciplinary Neurosurgery. 2019 Sep 1;17:79-83.
91. Simon F, Luscan R, Khonsari RH, Toubiana J, Belhous K, James S, Blauwblomme T, Zerah M, Denoyelle F, Donadieu J, Couloigner V. Management of Gorham Stout disease with skull-base defects: case series of six children and literature review. International Journal of Pediatric Otorhinolaryngology. 2019 Sep 1;124:152-156.
92. Chang K, Yang M, Li B, Huang H. Surgical management of Gorham‑Stout syndrome involving the cervical spine with bilateral pleural effusion: A case report and literature review. Exp Ther Med. 2020;19:3851–3855.
93. Hana Yokoi, Vikram Chakravarthy, Benjamin Whiting, Scott E. Kilpatrick, Tsulee Chen AK. Gorham-Stout disease of the spine presenting with intracranial hypotension and cerebrospinal fluid leak: A case report and review of the literature. Surg Neurol Int. 2020;11(466):1–4.
94. Chloe Gui1, Brett Rocos, Laura-Nanna Lohkamp, Angela Cheung, Robert Bleakney EM. Utility of the spinal instability neoplastic score to identify patients with Gorham-Stout disease requiring spine surgery. Surg Neurol Int. 2021;12(227):1–3.
95. Toga A, Watanabe K, Suzuki S, Nori S, Tsuji O, Nagoshi N, et al. Gorham-Stout Disease Resulting in Spinal Deformity Treated by Fusion Surgery Combined With Everolimus Therapy: A Case Report. JBJS case Connect. 2021;11(1):1–5.
96. Harman YG and F. The loneliness of a long-distance runner. A ten-year survey of a patient diagnosed with Gorham-Stout syndrome at the occipitocervical junction. Br J Neurosurg. 2021;1–4.
97. Aleksey Evsyukov, Murodzhon Kosimshoev, Yuliy Kubetskyi EN and JR. Surgical treatment of a patient with Gorham-Stout disease of craniovertebral junction: case report and literature review. Br J Neurosurg. 2021;1–6.
98. Ashley Ann Thompson SP. Gorham- Stout disease of the mandible, manubrium and cervical spine presenting as bilateral chylothorax. BMJ Case Rep. 2021;14(1):1–3.
How to Cite this Article: Krishnan A, Agrawal P, Parmar V, Chauhan V, Degulmadi D, Mayi S, Ranjan R, Bali SK, Amin PC, Charde PR, Krishnan PA, Dave MR, Dave BR | Gorham Stout Disease- A Rare Disorder with Ambiguous Recommendations: A Systematic Review of literature | Back Bone: The Spine Journal | October 2022-March 2023; 3(2): 65-77. https://doi.org/10.13107/bbj.2022.v03i02.043
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