摘要
SAPHO syndrome是一種罕見的疾病，有時會誤診為感染性骨髓炎，給予長期抗生素治療；或當病人有原發性腫瘤病史時，誤診為腫瘤轉移。 我們報告一個有乳癌病史的病人合併患有SAPHO Syndrome。這個42歲女性在1997無因左側乳癌而開刀。當時的核醫檢查在右胸鎖關節處有異常的攝取。 一年後，病人開始抱怨前胸疼痛。再從1997到2003年，一系列的核醫檢查中，可發現在右胸鎖關節，腰椎，骶骼關節與左邊胸鎖關節都有漸進性異常之核醫攝取。而病人的疼痛是持續而加重的。而在2003年，更發現病人手掌與腳掌有異常之膿皰。 經過電腦斷層與核磁共振檢查後發現在兩邊胸鎖關節，腰椎，右側骶骼關節有著多發性不正常的骨質增生與周圍水腫。 我們基於病人的臨床症狀，一系列的胸部X光片，骨質異常增生與皮膚膿皰。腫瘤轉移是可以排除的，而診斷為SAPHO syndrome。
並列摘要
SAPHO syndrome is a rare disease, and may lead to misdiagnosis of infectious osteomyelitis, resulting in long-term treatment with antibiotics, or osteoblastic metastasis when the patient have primary tumor history. We report a case of SAPHO syndrome who had a primary cancer history. The patient was a 42-year-old patient suffered from left breast cancer and received operation in 1997. Bone scintigraphy showed uptake at right sternoclavicular junction. She started to complained about anterior chest wall pain one year later. Series of bone scintigraphy from 1997 to 2003 showed progressive uptake at right sternoclavicular junction, spine, sacroiliac joint and the left sternoclavicular junction. The pain persisted and progressed, and pustular skin lesions over palms and soles also developed in 2003. CT scan and MRI study revealed multifocal peculiar hyperostotic bone lesions involving bilateral sternoclavicular junction, lumbar vertebra, and right sacroiliac joint, with mild degree surrounding marrow edema around the lesions. Base on her clinical history, serial chest films, hyperostosis, and pustular skin lesions, possibility of bone metastasis was excluded and a diagnosis of SAPHO syndrome was made.
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