J Rheum Dis.  2012 Feb;19(1):59-62. 10.4078/jrd.2012.19.1.59.

A Case of Radiation Recall Myositis Induced by 5-FU and Cisplatin

• Ryu YS
• Jeon CH

• KMID: 2223123
• DOI: http://doi.org/10.4078/jrd.2012.19.1.59

Abstract

Radiation recall phenomenon is an inflammatory reaction which occurs at a previously irradiated area after the administration of causative agents, especially anticancer drugs. Radiation recall mostly involves skin and rarely affects internal organs. We, hereby, report a rare case of radiation recall myositis. A 51-years-old man visited the hospital due to pain and weakness of the left thigh. He had been diagnosed with a skin metastasis of pancreatic adenocarcinoma, at the left thigh and treated with radiotherapy and subsequent combination chemotherapy of 5-FU and cisplatin. After the 5th cycle of chemotherapy, the patient developed pain and weakness localized at the previous radiation field. An MRI revealed myositis of left gluteus medius muscle. Muscle biopsy showed no malignant cells or signs of infection. He was diagnosed as having radiation recall myositis and treated with steroid and NSAID. Soon after, pain and weakness gradually improved. Although rare, a possibility of radiation recall myositis should be considered when a patient with history of radiotherapy has a myopathy.

Keyword

Radiation recall; Myositis; 5-FU; Cisplatin

MeSH Terms

Adenocarcinoma
Biopsy
Cisplatin
Drug Therapy, Combination
Fluorouracil
Humans
Muscles
Muscular Diseases
Myositis
Neoplasm Metastasis
Skin
Thigh
Cisplatin
Fluorouracil

Figure

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  Figure 1 MRI of the thighs. (A) The contrast-enhanced fat-suppressed T1-weighted enhanced image of pelvis showed diffuse contrast enhancement in the femoral insertion site of the left gluteus medius muscle. (B) This lesion also showed intermediate signal intensity on fat-suppressed T2-weighted image. There was no bone erosion or cortical destruction around the lesion.

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