Chiriac Bozac M I, Big S A, Maxim R A, Georgescu C E, Crisan N, Gherman V
"Iuliu Hațieganu" University of Medicine and Pharmacy - Discipline of Endocrinology, 6th Medical Specialties Department.
Municipal Clinical Hospital - Urology, Cluj-Napoca.
Acta Endocrinol (Buchar). 2024 Apr-Jun;20(2):222-230. doi: 10.4183/aeb.2024.222. Epub 2025 Jan 18.
Sweet's syndrome (SS) or acute febrile neutrophilic dermatosis is a dermatological illness that can be described by tender erythematous plaques or nodules and acute onset fever. The etiology is multifactorial and is not fully understood. SS is separated in three subclasses: classical, malignancy-associated, and drug-induced. It was shown that this syndrome can reveal an underlying hematological or solid malignancy.
We report the case of a 55-year-old female patient referred to the Urology department for management of pheochromocytoma in the right adrenal gland, revealed by abdominal imaging in another medical unit during the evaluation and diagnosis of multiple mucocutaneous lesions, characterized by erythematous-violaceous plaques and nodules, and painful aphthous ulcers of the tongue. The eruption of each lesion was preceded by low-grade fever and chills. The hormonal profile highlighted the presence of elevated normetanephrines. We performed 3D laparoscopic transperitoneal right adrenalectomy after preoperative treatment with alpha blocker therapy. The clinical outcome was favourable, given that the cutaneous lesions started to heal after the surgery.
Sweet's syndrome in association with pheochromocytoma is a very rare condition, only few cases were described in literature to our knowledge. The multidisciplinary collaboration is extremely important in the management of such cases.
Sweet综合征(SS)或急性发热性嗜中性皮病是一种皮肤病,其特征为压痛性红斑斑块或结节以及急性发热。病因是多因素的,尚未完全明确。SS分为三个亚类:经典型、恶性肿瘤相关型和药物诱导型。已表明该综合征可能揭示潜在的血液系统或实体恶性肿瘤。
我们报告一例55岁女性患者,因右侧肾上腺嗜铬细胞瘤转诊至泌尿外科,该肿瘤在另一医疗单位进行腹部成像评估和诊断多发性黏膜皮肤病变时被发现,病变特征为紫红色斑块和结节以及舌部疼痛性阿弗他溃疡。每个病变出现之前均有低热和寒战。激素检查显示去甲肾上腺素水平升高。我们在术前用α受体阻滞剂治疗后进行了3D腹腔镜经腹右侧肾上腺切除术。鉴于术后皮肤病变开始愈合,临床结果良好。
Sweet综合征合并嗜铬细胞瘤是一种非常罕见的情况,据我们所知,文献中仅描述了少数病例。多学科协作在处理此类病例中极其重要。