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Thoracic Gorham-Stout disease masquerading as an ovarian malignancy: a differential diagnosis in non-malignant causes of raised Ca-125 and overview of this rare pathology
  1. Alisha Sattar,
  2. Sarah Smyth and
  3. Hooman Soleymani majd
  1. Department of Gynaecology Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  1. Correspondence to Dr Hooman Soleymani majd; hooman.soleymani{at}ouh.nhs.uk

Abstract

Gorham-Stout disease (GSD) is thought to be due to uncontrolled proliferation of vascular and lymphatic structures within bone tissue causing destruction and osteolysis of bone. We present a patient in her mid-40s who reported chronic shoulder pain, a pleural effusion and irregular periods. Investigations showed osteolysis of her ribs, pleural effusions, an ovarian mass and a raised carbohydrate antigen 125 (Ca-125). She was subsequently diagnosed with GSD, and referred to gynaecology-oncology in consideration of potential ovarian malignancy. GSD is a diagnosis of exclusion that requires a high degree of clinical suspicion, as well as multiple investigations to achieve diagnosis. Clinicians rely on a small number of case reports to provide guidance for this. Therefore, this report provides an overview of a rare pathology, considers the differentials of a raised Ca-125 and describes how a pleural effusion, which links them both, alarmed us regarding an incidental finding of an ovarian cyst.

  • Obstetrics and gynaecology
  • Respiratory medicine
  • Rheumatology

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Footnotes

  • Contributors HSM conceptualised the manuscript, and provided senior review and clinical patient care. SS provided senior review and clinical patient care, and drafted the manuscript. AS performed the primary literature review and manuscript drafting and provided clinical patient care.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.