Disappearing bone disease is a rare condition and usually affects young adults. Its aetiology is not known. A case of a 12-year-old female child, who had a fall and sustained a fracture mid shaft of femur and supracondylar region, is reported. On follow-up subsequent X-ray showed extensive osteolysis which was progressively affecting the other side of the pelvic girdle and femur. She was put on trial of calcitonin 50 IU by nasal spray for six months but there was no improvement. However, during the past three and half years the disease process had progressively extended to the other side of pelvic girdle and femur with fatal outcome. To the knowledge of the authors such progression in a short time has not been reported in any case so far.
Multicentric disappearing bone disease, or Gorham disease, is a rare entity. A middle age woman, presented to us with left sided antalgic gait and severe bony deformity of her left knee. Radiograph revealed massive bone defect of the medial condyle of the left tibia with subluxation of the knee joint. She was scheduled for knee replacement in six months. However, she developed another lesion over the right hip that typically mimicked the disease progression of disappearing bone disease. The right femoral head vanished progressively within three months without significant history of infection or trauma. Subsequent bone biopsy of the right femoral head and left tibia condyle confirmed the diagnosis. Total knee replacement was carried out for her left knee. She remained pain free on her left knee. A year later, after confirming by sequential radiographs that the osteolysis had stopped, total right hip replacement was performed. Five years later, she remained pain free and both the arthroplasties were stable.
Gorham disease (GD) is an extremely rare disorder that is characterised by massive osteolysis of the affected bone with unknown aetiology and an unpredictable prognosis. Additionally, no standard treatment is available for GD. This article describes a case report of a 61-year-old Malay woman who was diagnosed with GD of the anterior mandible without a prior history of trauma. She presented with pain and mobility of the dentoalveolar segment for 3 months. The radiographic findings showed "floating teeth" with widening of the periodontal ligament space and localized area of bony destruction. Histopathologically, there was proliferation of numerous dilated endothelial-lined channels within the intertrabecular tissue. Some areas of bone were replaced by fibrous connective tissue giving rise to the appearance of a benign fibroosseous lesion. The patient was managed with simple removal of the affected bone segment under local anaesthesia, followed by prosthodontic rehabilitation. Healing of the surgical site was uneventful, and no recurrence was reported at the 3-year follow-up.