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J Rheum Dis. 2017 Oct;24(5):313-317. English. Case Report. https://doi.org/10.4078/jrd.2017.24.5.313
Kim HR , Ahn JS , Noh JH , Jeon HJ , Oh JS , Choi SW , Lim DH .
Division of Rheumatology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. dlaengh@hanmail.net
Division of Rheumatology, Department of Internal Medicine, National Medical Center, Seoul, Korea.
Abstract

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.

Copyright © 2019. Korean Association of Medical Journal Editors.