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Antineoplastic therapy for miscellaneous benign diseases affecting soft tissue and bone

Author
Thomas F DeLaney, MD
Section Editor
Robert Maki, MD, PhD
Deputy Editor
Diane MF Savarese, MD

INTRODUCTION

The majority of benign soft tissue masses are usually non-neoplastic and of little clinical consequence. However, some locally aggressive fibromatoses (desmoid tumors), infiltrating lipomas, neurofibromas, and vertebral hemangiomas may cause significant morbidity and, in some cases, mortality.

Radiation therapy for a variety of benign diseases affecting soft tissue and bone will be reviewed here. These include Gorham's disease, desmoplastic fibroma of bone, pigmented villonodular synovitis (tenosynovial giant cell tumor), and symptomatic vertebral hemangiomas. Radiation therapy for other conditions affecting soft tissue, such as desmoid tumors, keloid, ganglia, and Dupuytren's contracture, is discussed separately. (See "Desmoid tumors: Epidemiology, risk factors, molecular pathogenesis, clinical presentation, diagnosis, and local therapy" and "Keloids and hypertrophic scars" and "Ganglion cysts of the wrist and hand" and "Dupuytren's contracture", section on 'Other interventions'.)

GORHAM'S DISEASE

Gorham's disease (also known as Gorham-Stout disease, disappearing bone disease, or essential osteolysis) is a rare disorder characterized by relatively painless bone destruction with massive osteolysis due to progression of lymphangiomatous tissue [1]. There may also be significant osteoclast activation. Why this occurs is not clear, but increased levels of interleukin-6 may contribute to the osteolysis [2].

The pattern is that of lytic destruction of cortical bone and extension across joints to the adjacent bone. There is usually little or no soft tissue mass.

Treatment — Treatment consists of resection, when this is feasible from the standpoints of the medical condition of the patient, the technical aspects of the procedure, and the likelihood of retained function. There is anecdotal evidence that radiation therapy (RT) also may be effective [3-5]:

     

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Literature review current through: Nov 2016. | This topic last updated: Mon May 09 00:00:00 GMT+00:00 2016.
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