title: A child with gemcitabine-induced severe radiation recall myositis resulting in a compartment syndrome.
abstract: Chemotherapeutic induction of radiation recall (RR) is a rare event in which a chemotherapeutic agent given days to years after radiation therapy causes an inflammation reaction of the tissues within the irradiated area-"recalling" increased radiation effects to that area. In this unique case, a 14-year-old girl with a synovial sarcoma of the forearm was treated with neoadjuvant chemotherapy and radiation therapy. Gemcitabine was administered in an adjuvant setting inducing a RR reaction. The severity of the inflammation resulted in a forearm myositis secondarily causing a compartment syndrome that was treated with several prolonged courses of corticosteroids. The symptoms of RR and compartment syndrome have resolved 1 year postonset, although magnetic resonance imaging continues to show myositis and soft-tissue edema. This case highlights the need to maintain a heightened awareness to recognizing the signs and symptoms of RR and the potential severity of RR in pediatric cancer patients in conjunction with chemotherapeutic agents used more frequently in adults.
authors.affiliation: Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Eckardt
authors.forename: Adrienne
authors.initials: A
authors.lastname: Bean
authors.forename: Michael T
authors.initials: MT
authors.lastname: Selch
authors.forename: Noah
authors.initials: N
authors.lastname: Federman
mesh_terms: D000293:Adolescent; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003161:Compartment Syndromes / Q000209:etiology*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D011855:Radiodermatitis / Q000139:chemically induced / Q000150:complications*; D013584:Sarcoma, Synovial / Q000628:therapy; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine