Indolent systemic mastocytosis limited to the bone: a case report and review of the literature

Sao Paulo Medical Journal

Pedro Pinto-lopes¹  Francisco Adao Fonseca¹  Roberto Silva¹  Pedro Von Hafe¹  Elsa Fonseca¹ 

关键词: Mastocytosis;    Myeloproliferative disorders;    Musculoskeletal diseases;    Osteoporosis;    Low back pain;    Mastocitose;    Transtornos mieloproliferativos;    Doencas musculosqueleticas;    Osteoporose;    Dor lombar;   

DOI  :  10.1590/1516-3180.2013.1313460

来源: SciELO

【 摘 要 】

CONTEXT Systemic mastocytosis is defined as a clonal disorder of mast cells and their precursor cells and is currently classified as a myeloproliferative neoplasm. Its clinical course has a wide spectrum, ranging from indolent disease, with normal life expectancy, to highly aggressive disease, associated with multisystemic involvement and poor overall survival. The aim of this study was to report a case of indolent systemic mastocytosis, focusing on the diagnostic challenges, with a review of the literature. CASE REPORT A 79-year-old Caucasian woman with osteoporosis was evaluated at the Emergency Department because of complaints of low back pain. Before this, she had consulted an orthopedist and had undergone some imaging examinations, namely a bone scan that revealed a “superscan” pattern. Due to her pain complaints and these test results, the patient was admitted to the Department of Internal Medicine. After undergoing several analytical tests and some additional imaging examinations to rule out some important differential diagnoses, she then underwent bone marrow biopsy, which made it possible to identify indolent systemic mastocytosis. CONCLUSION Systemic mastocytosis is a rare entity that is difficult to diagnose. Its symptoms are often unspecific and frequently ignored. Skeletal changes may be the first and only manifestation of the disease and in some cases, like this one, the diagnosis is made only after histological examination. The key point for the diagnosis is to contemplate the possibility of systemic mastocytosis.

【 授权许可】

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