4th Medical Clinic, Cluj-Napoca, Romania.
J Gastrointestin Liver Dis. 2009 Dec;18(4):483-6.
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.
我们报告首例胰腺错构瘤与 SAPHO 综合征相关的病例，该病例表现为类似于骨转移的弥漫性骨病变。患者为 46 岁男性，10 年前出现间歇性背痛，经 NSAIDs 治疗和脱皮性红斑掌跖疹缓解，1 年前出现十二指肠狭窄、胰头部囊性肿瘤以及锁骨、下颌骨、腰椎成骨（骨质增生）和破骨（骨炎）病变。骨病变类似于骨转移，但左锁骨切除活检显示炎症浸润和纤维化，符合 SAPHO 综合征的表现。胰腺肿瘤生长迅速，腹腔镜检查显示组织学上具有恶性特征。行胰头十二指肠切除术，但组织学检查结果确立了胰腺错构瘤的诊断。几个月后，骨 Tc99m 闪烁扫描正常。
