Case Report

Radiation-Induced Myositis in a Patient Recently Treated with Gemcitabine

Leonardo Gomes da Fonseca^*
Cancer Institute of Sao Paulo State, University of Sao Paulo, Av. Dr. Arnaldo 251, São Paulo, São Paulo, Brazil

^*Corresponding author: Leonardo Gomes da Fonseca, Cancer Institute of Sao Paulo State, University of Sao Paulo, Brazil

Published: 14 Jun, 2017
Cite this article as: da Fonseca LG. Radiation-Induced Myositis in a Patient Recently Treated with Gemcitabine. Clin Oncol. 2018; 3: 1405.

Clinical Image

A 20-year-old-man with metastatic fibrolamellar hepatocellular carcinoma developed a painful metastatic lesion in the proximal third of the left femur. A course of palliative radiotherapy directed to this lesion was performed. Immediately after the treatment, the bone pain disappeared. However, 4 weeks after the radiotherapy the patient developed pain and swelling in the left hip, which caused severe functional limitation. At the physical examination, the skin and muscles were markedly indurated. A MRI was performed and revealed findings of acute myositis. The patient was started on oral dexamethasone with progressive improvement, but the symptoms returned when dexamethasone was weaned. A maintenance dose was required for 3 months until complete recover. One month before the radiotherapy, the patient had received gemcitabine as systemic treatment. According to the definition, it is not possible to define this event as a radiation recall, but the intensity of the inflammation observed may suggest an unusual radiosensitizating effect of gencitabine.

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