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KMID : 1084220170240050313
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Journal of Rheumatic Diseases
2017 Volume.24 No. 5 p.313 ~ p.317
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Pancreatic Neuroendocrine Tumor Presenting with Arthritis and Panniculitis
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Kim Hyung-Rae
Ahn Jae-Sung
Noh Jin-Hee
Jeon Hee-Jeong
Oh Ji-Seon
Choi Seung-Won
Lim Doo-Ho
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Abstract
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Pancreatic neoplasm is complicated and can be preceded by extra-pancreatic manifestations, such as cutaneous and musculoskeletal symptoms. Awareness of these associations is important for timely diagnosis and appropriate treatment. We report a case of pancreatic neuroendocrine tumor (NET) presenting with arthritis and panniculitis. The patient had a two month history of right knee pain and subcutaneous nodules in both legs. Synovial fluid analysis from the right knee joint revealed a mildly increased white blood cell count without crystallization. A skin biopsy of a subcutaneous nodule revealed lobular panniculitis. The initial treatment with empirical antibiotics did not alleviate the symptoms; however, the right knee arthritis and skin nodules improved with steroid treatment. On the eighth day of hospitalization, the patient complained of abdominal discomfort. Abdominopelvic computed tomography scanning revealed a 14-cm sized pancreatic mass with peritoneal metastasis. Percutaneous needle biopsy confirmed the diagnosis of pancreatic NET.
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KEYWORD
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Pancreatic neoplasms, Neuroendocrine tumors, Arthritis, Panniculitis
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