Lymphangiomatosis and massive osteolysis of the cervical spine. A case report and review of the literature.

On the basis of clinical, radiographic, and pathologic evidence, massive osteolysis can be divided into two forms: Gorham's disease and angiomatosis. The present case is the first report of massive osteolysis of the lymphangiomatosis type involving the cervical spine but without visceral involvement. Originally, plain lymphangiomatosis was diagnosed, but the diagnosis was changed to massive osteolysis. Only one other case of lymphangiomatosis with cervical involvement was found, but in that case the viscera were also involved. Both cases exemplify a prolonged progressive pattern, recalcitrant to treatment and with a devastating outcome. Diagnosis by biopsy is difficult, and incremental radiation therapy early in the disease process should be considered.