Pancreatic hamartoma and SAPHO syndrome: a case report.
We report the first case of an association of pancreatic hamartoma with SAPHO syndrome mimicking disseminated bone metastases. A 46 year old male with intermittent back pain for 10 years, relieved by NSAIDs and desquamation erythemathous palmo-plantar eruption one year before, presented with symptoms of duodenal stenosis, a cystic tumor at the head of the pancreas and osteoformative (hyperostosis) and osteodestructive (osteitis) lesions of the clavicle, mandible, lumbar spine. The bone lesions resembled bone metastases, but an inflammatory infiltrate and fibrosis were found on the excisional biopsy of left clavicle, compatible with the SAPHO syndrome. The pancreatic tumor grew rapidly and showed a histological aspect of malignancy at laparoscopy. A cephalic duodenopancreatectomy was performed, but the histological findings established the diagnosis of pancreatic hamartoma. Several months later, the bone Tc99m scintigraphy was normal.
Sampelean
Dorel
D
4th Medical Clinic, Cluj-Napoca, Romania. steelnox78@yahoo.com
Adam
Mircea
M
Muntean
Valentin
V
Hanescu
Bianca
B
Domsa
Iacob
I
D020083:Acquired Hyperostosis Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis; D002968:Clavicle / Q000473:pathology; D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D004380:Duodenal Obstruction / Q000209:etiology; D019160:Endosonography; D006222:Hamartoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008334:Mandible / Q000473:pathology; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016577:Pancreaticoduodenectomy; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome