Gorham’s Disease that Gave Response to Radiotherapy
Sule Karabulut Gul,
Ahmet Fatih Oruc,
Duygu Gedik,
Hakan Levent Gul,
Atınc Aksu,
Alpaslan Mayadagli
Issue:
Volume 2, Issue 5, September 2014
Pages:
45-47
Received:
24 August 2014
Accepted:
9 September 2014
Published:
20 September 2014
Abstract: Background: Gorham’s disease is a disorder that results as destruction and resorption of osseous matrix and is characterized by proliferation of vascular channels. We here reported a rare case of Gorham’s disease that gave response to radiotherapy. Our aim is to remind the clinicians about this rare entity, and to discuss the etiopathology, clinical presentation and treatment options for patients with Gorham’s disease. Case Report: 32 years old male patient had admitted to neurosurgery department for pain, weakness and limitation of motion at the head and neck. Osteolysis was detected at the bodies of 1, 2 and 3. vertebrae. After a number of examinations and excisional biopsy, the patient was diagnosed as Gorham’s disease. Cervical stabilization was made but after 3 years, the patient’s complaints had occurred again and a restabilization was made. 2 years after; with increased complaints, the patient was send to our clinic for consultation and radiotherapy (RT) was applied to the destructive parts of the bones. 2 months after RT, the patients’ complaints had a significant decrease both clinically and radiologically. Conclusion: Gorham’s disease can be seen in both men，women and at any age group, although most cases are diagnosed before the age of 40 years. No familial predisposition has been found. The disease may affect the appendicular or the axial skeleton. The exact nature of the disease process is unknown. The medical treatment for Gorham’s disease includes radiation therapy, anti-osteoclastic medications (bisphosphonates), and alpha-2b interferon. As laboratory studies are usually within normal limits in most cases, diagnosis can often be delayed. By the light of clinical findings with characteristic radiographic and histopathological findings, an early diagnosis can be possible.
Abstract: Background: Gorham’s disease is a disorder that results as destruction and resorption of osseous matrix and is characterized by proliferation of vascular channels. We here reported a rare case of Gorham’s disease that gave response to radiotherapy. Our aim is to remind the clinicians about this rare entity, and to discuss the etiopathology, clinica...
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Striking Regression of Temporal Lobe Necrosis Following Radiotherapy for Nasopharyngeal Carcinoma in a Clinical trial of Anti-Mycobacterium Therapy
Yanqing Feng,
Weixi Zhang,
Xi Chen,
Zhenhua Gao,
Minying Zheng,
Ning Guo,
Fan Huang,
Ke Ma
Issue:
Volume 2, Issue 5, September 2014
Pages:
48-55
Received:
30 August 2014
Accepted:
22 September 2014
Published:
30 September 2014
Abstract: The mechanism of radiation-induced delayed brain injuries remains poorly understood, and few treatment options are available. The aim of this study was to investigate whether temporal lobe necrosis can be reversed by anti-mycobacterium therapy (AMT). We conducted this prospective, controlled study in southern China. Ten patients with symptomatic delayed radiation injury were monitored during AMT and compared with a control group of 11 patients who received current standard therapies. Activities of daily living were assessed by the Barthel Index (BI) at study entry and after 2 years of therapy. Magnetic resonance imaging (MRI) was performed before treatment, and changes were monitored during the study. Kaplan–Meier analysis was employed to delineate time-related mortality. A significant treatment effect was observed in the AMT group. The patients’ headaches, seizures, dizziness, and cognitive deterioration rapidly improved. BI improved in the AMT treatment group compared with the control group after 2 years (Mann–Whitney U test; P=0•001). Abnormalities of the temporal lobes, observed by MRI, markedly decreased over time in eight patients, whereas in the control group significant BI deterioration was observed (Wilcoxon signed-rank test; P=0•003) and the patients did not show favorable MRI changes. By 24 months, there was a significant difference between the AMT and control groups with respect to survival time (log-rank test; P=0•011). The results of the present study suggest that radiation necrosis of the brain can be successfully managed by AMT. These findings must be confirmed in large, double-blind, randomized clinical trials.
Abstract: The mechanism of radiation-induced delayed brain injuries remains poorly understood, and few treatment options are available. The aim of this study was to investigate whether temporal lobe necrosis can be reversed by anti-mycobacterium therapy (AMT). We conducted this prospective, controlled study in southern China. Ten patients with symptomatic de...
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