Hemangiomatosis Associated with Osteolysis of the Mandible in a Dog Resembling Gorham-Stout Disease in Humans

Abstract

Abstract.A 6-month-old female German Shepherd Dog died as a result of profuse oral bleeding. At postmortem examination, the oral cavity showed visible roots of the right mandibular fourth premolar and first molar teeth and, in addition, they were very mobile and compressible. Radiographs showed a generalized radiolucency in the body of the right mandible, with evidence of resorption of the affected alveolar bone. Histologically, the lesion of the right mandible was characterized by the lysis of bony structures and a nonmalignant proliferation of blood-filled vascular spaces lined by a single layer of well-differentiated endothelial cells. The clinical, radiographic, and histologic presentation of this dog is consistent with that associated with Gorham-Stout disease, a rare bone disorder in humans.Key words: Bone; disappearing bone disease; dogs; Gorham disease; mandible; osteolysis.A 6-month-old female German Shepherd Dog initially presented to the Hospital Veterinario Rof Codina for intermittent oral bleeding without a history of significant trauma or discomfort. Physical examination showed the presence of fractured and mobile lower right canine and first premolar deciduous teeth with accompanying gingival hemorrhage. After extraction of the fractured teeth and surgical suture, bleeding apparently stopped. Five weeks after the initial presentation, the dog was returned to the Hospital with acute oral bleeding. The laboratory data showed hematocrit and hemoglobin readings of 8.1% (reference range, 37-55%) and 2.5 g/dl (reference range, 12-18 g/dl), respectively; coagulation parameters were within normal laboratory ranges. Bleeding originated from the gingiva around the teeth of the right mandible, but attempts to arrest it were unsuccessful because the exact source of the hemorrhage could not be identified. In spite of the prescribed treatment and transfusion of whole blood, the dog died.At postmortem examination, gross pathologic findings were limited to the body of the right half of the mandible. The roots of the fourth premolar and first molar teeth were readily visible because of marked gingival recession accompanied by an enlargement of the bony alveoli (Fig. 1). Both teeth were very mobile, and when compressed, they introduced deeply into the body of the mandible. There was no associated gingivitis. Dissection of the mandible showed a loss of the affected alveolar and adjacent bone and, in addition, an area of absence of cortical bone of 1 cm in diameter in the lateral surface of the right mandibular body, ventral to the third premolar. The affected mandibular bone showed no nodules or enlargement, and no abnormalities were identified at the rostral extremity of the body and ramus of the right mandible or at the left half of the bone. These postmortem findings indicated direct trauma to the inferior alveolar vessels of the right mandibular canal by the mobile teeth as the origin of the hemorrhage.The dissected mandible was thereafter subjected to a radiographic study. Radiographs demonstrated a large area ...

Massive osteolysis in a dog resembling Gorham’s disease in humans

“…The pathology in these dogs was compared to Winchester syndrome in humans, because lysis was multicentric, bone was replaced by fibrous rather than vascular tissue, and three of the four dogs were related (lineage of the fourth dog was unknown). A second case report described an immature German shepherd dog that died as a result of profuse oral bleeding (8). In this dog, the clinical, radiographical, and histological presentation was similar to Gorham's disease, although the primary differential diagnosis of primary haemangioma could not be ruled out.…”

“…We describe the clinical, radiological and histopathological features, and discuss similarities with the human condition known as Gorham's disease. Although two previous reports of canine idiopathic osteolysis have been published, to the authors' knowledge, this is the first case report documenting the natural progression of idiopathic primary osteolysis in a dog (7,8).…”

“…We have described a case of massive polyostotic osteolysis involving the spine and pelvis of an immature dog. Prior to treating this dog, we were aware of only two previous case reports describing idiopathic osteolysis in the veterinary literature (8,10). One case report described four adult Scottish terriers with multifocal absence of bone in the skull, cervical spine, antebra-chii, and femora (8).…”

A Rare Case of Vascular Proliferation in the Mandible of a Juvenile Horse

“…Accordingly, the term angiomatosis has been used ambivalently in literature to describe both, neoplastic, as well as malformative, proliferative vascular lesions (11)(12)(13). Cases of mandibular angiomatosis have been reported in young animals before, including a 2-month-old Holstein calf and a 6-month-old dog from Canada and Spain, respectively (14,15). Similar lesions have been observed in the orbit, the meninges, ovaries, intestine, and skin of horses but, to the authors' knowledge, have never been observed within the mandible (11)(12)(13)16).…”