Pancreatic Hamartoma and SAPHO Syndrome: a Case Report
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Dorel Sampelean1, Mircea Adam1, Valentin Muntean2, Bianca Hanescu1, Iacob Domsa1
1) 4th Medical Clinic;
2) 4th Surgical Clinic, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
Abstract
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.
Key words
SAPHO syndrome - pancreatic hamartoma - osteitis - palmoplantar eruption - hyperostozis.
