Au sein des vascularites systémiques se dégage le syndrome de MacDuffie qui comporte l'association, chez une femme le plus souvent, de poussées d'urticaire, d'angio-œdème, de manifestations articulaires et de douleurs abdominales; l'atteinte rénale peut grever le pronostic de la maladie. L'hypocomplémentémie touchant surtout la voie classique est de règle au moment des poussées. La corticothérapie est le traitement habituel. Nous rapportons une observation qui correspond à ce cadre nosologique mais présente deux particularités: d'une part l'existence d'une lyse de l'extrémité externe de la clavicule droite alors que classiquement les lésions articulaires ne sont pas destructrices; d'autre part l'efficacité des anti-inflammatoires non stéroïdiens avec un recul d'un an sans complication.

MacDuffie's syndrome emerges from systemic vasculitis as including recurrent urticaria-like skin lesions, episodic angio-oedemas, articular manifestations and abdominal pains, with a tendency to affect women. Renal involvement may burden the prognosis. Hypocomplementemia is usual by deficiency of the classical pathway. Corticosteroid therapy is habitual. The case reported, fitting to this nosological entity offers two new features: in the first place, the osteolysis of the distal part of the clavicle whereas the joints are not affected by destroying lesions; then the non steroidal anti-inflammatory drugs was effective within a period of one year without complication.

The authors report a series of 13 cases of bony metastases leading to the discovery of a hepatoma. They were subjects of male sex, average age 64 years. Nine were severe alcoholics. The presenting symptoms were in 7 cases neurological, in four cases an isolated bone tumour, finally, one spontaneous fracture, and one case with pain alone. Severe loss of weight was frequent; in 10 cases out of 13 it was greater than 5 kg. Hepatomegaly was found in 8 cases, but in 3 cases there was no sign suggesting liver disease. In 7 cases out of nine, the metastases were already numerous at the time of diagnosis. The diagnosis of metastases from a hepatoma was made on the bone histology 11 times and from the hepatic histology in 6 cases. The histological of the bone metastasis reproduces very well that of the liver. In four cases there was local secretion of bile, in one case the metastatic liver cells underwent steatonecrosis.