Gorham Disease of Mandible-Diagnostic Challenge: A Case report

Gorham disease is a rare entity of unknown aetiology characterised by the progressive destruction of osseous matrix, which is later replaced by proliferation of non neoplastic vascular tissue followed by dense fibrous tissue without bone regeneration. It was first described by Jackson in 1838. This condition can occur at any age and may affect any bone, however, in the skull, the maxilla and mandible are affected. Generally, the mandible is involved unilaterally. When the jaws are affected, tooth mobility is the first problem, and because of this diagnosis is difficult as it mimics periodontal diseases. Hereby, the authors present a case report of Gorham disease in a 38-year-old female, affecting the mandible bilaterally. The patient underwent multiple extractions from the maxilla and mandible due to tooth mobility. Severe alveolar ridge resorption was also evident in present case. Initially, radiolucent foci are present mimicking osteoporosis, followed by cortical erosion without a sclerotic border with pointing of the remaining osseous tissue, leading to the “licked candy stick deformity”, which was noted in the present case. Pathological fractures is common in the later stages. In present case, pathological fractures were present bilaterally in the angle of the mandible. A aetiology of this disease remains unclear to researchers. Diagnosis and treatment of such cases pose a challenge for clinicians.