Multiple photopenic vertebrae in the bone scintigraphy of a young man with Gorham’ disease: CT and MRI correlation

Introduction: We report a rare pattern of extensive bone abnormalities on the 99m Tc- MDP bone scintigraphy in a patient with Gorham disease.Case Report: Our case is a 28-year-old-man with a history of biopsy-proven soft tissue hemangioma in the left thigh, encountered with recent diagnosis of multiple vertebral hemangiomata in the axial skeleton and progressive bony destructions in the pelvis on CT and MRI images, referred for bone scintigraphy. Whole body bone scan and following SPECT acquisition were performed four hours after IV injection of 740 MBq (20mCi) 99m Tc- MDP. Multiple photopenic hemangiomata were noted on bone scan.Discussion: Vascular proliferation and replacement of bone matrix with fibrous tissue lead to bone destruction and osteolysis. The etiology of the disease is still unknown. Notably, suspicion of the vanishing bone disease should be considered only after excluding the other significant differential diagnosis such as infection, malignancy, inflammatory and endocrine pathologies. Despite the benign pathology of the disease, the prognosis is unpredictable with possible serious consequences like pathologic fractures.

Keywords:

Gorham disease , Bone resorption , Vascular proliferation , Hemangioma