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Paraspinal radiation recall myositis after gemcitabine for pancreatic adenocarcinoma
  1. Adriel Barrios-Anderson,
  2. Reshmitha Radhakrishnan,
  3. Esther Yu and
  4. Alexei Shimanovsky
  1. The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
  1. Correspondence to Mr Adriel Barrios-Anderson; adriel{at}


Radiation recall (RR) is a chemotherapy-induced reaction that leads to inflammation and necrosis in previously irradiated tissue. Gemcitabine is a cytidine analogue that is often used in conjunction with nab-paclitaxel in the treatment of pancreatic cancer. Herein, we present a case of a 56-year-old woman with stage III pancreatic adenocarcinoma diagnosed with gemcitabine-induced RR when she presented with lower back pain and new rim-enhancing collections within the right and left paraspinal musculature 5 months after radiation therapy to the pancreas. A PubMed search was performed for ‘Radiation Recall Myositis’ and a complete literature review performed. This case and review of the literature of published cases of RR myositis highlight the clinical course and presentation of RR myositis. This review highlights the importance of considering RR in the differential diagnosis when patients who are undergoing chemotherapy and radiation present with inflammatory changes in previously irradiated areas.

  • chemotherapy
  • pancreatic cancer
  • radiotherapy

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  • Contributors We would like to verify that the requirements by BMJ Case Reports for authorship have been met and each author believes the manuscript represents authentic work. AB-A prepared the manuscript draft and conducted the literature review and subsequent analysis. RR was the patient’s provider and revised the manuscript. EY prepared and revised the manuscript. AS was the primary provider in the case on the patient’s initial presentation and, at readmission, prepared and revised the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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