Massive Osteolysis of the Mandible in Gorham's Disease: Our Case Experience

Abstract

Vanishing bone disease is an exceptionally rare condition marked by the progressive loss of bone, ultimately leading to its complete disappearance. The cause of this disease remains unknown, and it primarily affects the axial skeleton, pelvis, and humerus. Due to its atypical presentation and rarity, it is often mistaken for other disorders, making an accurate diagnosis challenging and typically a process of elimination. Gorham's disease has been documented in the maxillofacial region, with most involving the mandible. We present a case involving a 14-year-old male patient who exhibited Gorham's disease in the right mandible, characterized by the loosening of teeth.

Keywords: disappearing bone disease; gorham’s disease; idiopathic osteolysis; massive osteolysis; phantom bone disease; spontaneous bone resorption; vanishing bone disease.

Figure 1. Teeth in the lower right quadrant appeared displaced.

Figure 2. Deviation of the mandible evident toward the ipsilateral side.

Figure 3. A panoramic radiograph revealed an excessively thin bone rim with a pathological fracture in the right body of the mandible.

Figure 4. Computed tomography of the head and neck region (3D reconstruction images) showed severe osteolytic changes involving the right mandible.

Figure 5. Surgical steps.

A: The extraoral submandibular incision marking was done. B: A meticulous dissection was done, and a thorough exploration of the mandible was conducted to assess the extent of the damage. C: The mandible was reconstructed using a load-bearing plate to restore its form and function.

Figure 6. Immediate postoperative OPG.

OPG: Orthopantomogram

Figure 7. After a four-month follow-up, it was noted that the chin deviation had been reduced.