A Case of Gorham–Stout Disease of the Pelvis Treated with Radiation Therapy

Case RepoRtThe patient was placed in a supine position with a customized thermoplastic pelvic immobilization mask and had a CT simulation with intravenous contrast.To the radiotherapy planning system, CT images were imported.The primary image dataset was fused with IntroductIonGorham-Stout disease (GSD) is a rare and uncommon, locally destructive musculoskeletal disorder.When Gorham and Stout reported cases of the disease with obvious hemangiomatosis in 1955, it was unknown that Jackson had first mentioned the condition in a medical article in 1883 as a boneless arm. 1,2orham-Stout disease is sometimes referred to as vanishing bone disease or massive osteolysis.Progressive bone resorption and angiomatous or lymphangiomatous tissue replacement are hallmarks of GSD.The exact mechanisms behind bone resorption are not fully understood: a disruption of osteoblast-osteoclast balance due to hyperemia, increased hydrolytic enzyme activity, increased osteoclast precursor activity by humoral factors, and enhanced osteoclast activity due to elevated interleukin-6 levels. [3][4]][5] Approximately, 400 cases of GSD have been reported in recent literature.The disease can affect any age-group.Although GSD can occur in any part of the body, it is most frequently found in the skull, ribs, shoulders, and pelvis.Additionally, GSD affecting the pelvis is often surgically unresectable due to higher morbidity.Despite the fact that surgery is the primary treatment for GSD, previous studies have shown that the condition is radiosensitive, and radiation therapy (RT) is recommended for refractory or symptomatic cases that cannot be treated medically.