Evidence map›Paper›PMID 42438615›Full record

ReviewCureus2026

Therapeutic Efficacy of Sirolimus in Skeletal Manifestations of Gorham-Stout Disease in Adults: A Systematic Review.

Michal Mierzejewski, Sylwia Olizarowicz, Zofia Kania-Bonicka, Michal Majewski, Paulina Szczepanska

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Michal MierzejewskiFaculty of Medicine, Medical University of Warsaw, Warsaw, POL.
Sylwia OlizarowiczFaculty of Medicine, Medical University of Warsaw, Warsaw, POL.
Zofia Kania-BonickaFaculty of Medicine, Medical University of Warsaw, Warsaw, POL.
Michal MajewskiFaculty of Medicine, Medical University of Warsaw, Warsaw, POL.
Paulina SzczepanskaDepartment of Dentistry, Masovian Dental Center, Warsaw, POL.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gorham-Stout disease (GSD) is a rare condition characterized by progressive osteolysis and abnormal proliferation of lymphatic vessels. Its pathogenesis involves PI3K/AKT/mTOR pathway hyperactivation, providing a molecular basis for the application of targeted mTOR inhibitors such as sirolimus. This study aims to systematically review the efficacy and safety of sirolimus in treating adult patients with GSD presenting with skeletal manifestations. A systematic review was conducted in accordance with PRISMA 2020 guidelines using PubMed, Scopus, and EMBASE databases. Data from eligible case reports involving adult patients were extracted and analyzed through a qualitative narrative synthesis. Nine case reports involving 9 patients (mean age 39.3 years) met the inclusion criteria. Patients presented with extensive polyostotic involvement and severe complications such as massive pleural effusions or recurrent chylothorax. Sirolimus therapy yielded a therapeutic response in seven out of nine patients, including two complete and five partial responses. Data from these nine case reports suggest that the intervention may effectively halt active osteolysis and promote the resolution of effusions. While the therapy successfully arrested disease progression and induced significant localized bone formation, complete anatomical reossification of all osteolytic lesions was not achieved in the adult cohort. The treatment was generally well-tolerated, with manageable adverse events (acne, mild mouth sores, hyperlipidemia, nausea, and respiratory infection). Targeted sirolimus therapy serves as a potential therapeutic option for adult GSD. It necessitates a long-term, multimodal approach, including concurrent anti-resorptive and continuous imaging follow-up. Current evidence is limited by the reliance on heterogeneous case reports. Multicenter prospective registries or international collaborative cohorts are required to validate our results and establish standardized dosing guidelines.

Indexed as

gorham-stoutosteolysisrapamycinsirolimusvanishing bones

Identifiers

PMID42438615
PMCPMC13356887

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.