Is angiomatosis an intrinsic pathohistological feature of massive osteolysis? Report of an autopsy case and a review of the literature

We report here an autopsied patient who had died during the clinical course of massive osteolysis (MO), which is a rare chronic disease that begins insidiously and is characterized by progressive regional loss of bone. Since the original description by Gorham and Stout in 1955, vascular proliferation, e.g., hemangiomatosis, has been considered to be the characteristic feature related to the pathogenesis. However, no such vascular changes were observed in the present patient. It was also important to note that a significant number of cases of MO that showed no vascular proliferation have been described previously. Therefore, we consider that vascular proliferation is not always associated with the osteolysis in MO and that the increased vascularity, if any, may be one of the results of the disease rather than the cause.