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Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report

PURPOSE: Radiation recall dermatitis (RRD) is a rare complication that occurs after completion of radiation therapy (RT) and initiation of a precipitating agent, most commonly chemotherapeutic medications. Various theories attempt to explain the mechanism, including activation of the body's inf...

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Autores principales: Liu, I-Chia, Giap, Fantine, Mailhot-Vega, Raymond B., Bradley, Julie A., Mendenhall, Nancy P., Okunieff, Paul, Lu, Li, Jantz, Michael A., Daily, Karen, Spiguel, Lisa, Lockney, Natalie A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443621/
https://www.ncbi.nlm.nih.gov/pubmed/32884534
http://dx.doi.org/10.1159/000508493
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author Liu, I-Chia
Giap, Fantine
Mailhot-Vega, Raymond B.
Bradley, Julie A.
Mendenhall, Nancy P.
Okunieff, Paul
Lu, Li
Jantz, Michael A.
Daily, Karen
Spiguel, Lisa
Lockney, Natalie A.
author_facet Liu, I-Chia
Giap, Fantine
Mailhot-Vega, Raymond B.
Bradley, Julie A.
Mendenhall, Nancy P.
Okunieff, Paul
Lu, Li
Jantz, Michael A.
Daily, Karen
Spiguel, Lisa
Lockney, Natalie A.
author_sort Liu, I-Chia
collection PubMed
description PURPOSE: Radiation recall dermatitis (RRD) is a rare complication that occurs after completion of radiation therapy (RT) and initiation of a precipitating agent, most commonly chemotherapeutic medications. Various theories attempt to explain the mechanism, including activation of the body's inflammatory pathways through nonimmune activation. Likewise, radiation-induced organizing pneumonia (RIOP) is an infrequent but potentially life-threatening complication of RT that, while not fully understood, is suspected to be partly an autoimmune reaction. PATIENT: We present the case of a 71-year-old female with a history of type 2 diabetes mellitus, hypothyroidism, interstitial cystitis, and osteoarthritis who presented with clinical stage T1N0M0 ER+/PR–/HER2– invasive ductal carcinoma of the lower outer quadrant of the left breast, for which she underwent left segmental mastectomy and sentinel lymph node biopsy followed by completion axillary lymph node dissection. Her final pathologic stage was T1N1M0. RESULT: The patient developed RRD and later RIOP following receipt of radiation and chemotherapy, which resolved with steroid administration. CONCLUSIONS: The rarity of both RRD and RIOP occurring in a patient, as in our case, suggests a shared pathophysiology behind these two complications. As both reactions involve some degree of inflammation and respond to corticosteroids, it seems likely that the etiologies of RRD and RIOP lie within the inflammatory pathway. However, further investigation should evaluate the frequency, duration, and triggering of concomitant RRD and RIOP.
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spelling pubmed-74436212020-09-02 Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report Liu, I-Chia Giap, Fantine Mailhot-Vega, Raymond B. Bradley, Julie A. Mendenhall, Nancy P. Okunieff, Paul Lu, Li Jantz, Michael A. Daily, Karen Spiguel, Lisa Lockney, Natalie A. Case Rep Oncol Case Report PURPOSE: Radiation recall dermatitis (RRD) is a rare complication that occurs after completion of radiation therapy (RT) and initiation of a precipitating agent, most commonly chemotherapeutic medications. Various theories attempt to explain the mechanism, including activation of the body's inflammatory pathways through nonimmune activation. Likewise, radiation-induced organizing pneumonia (RIOP) is an infrequent but potentially life-threatening complication of RT that, while not fully understood, is suspected to be partly an autoimmune reaction. PATIENT: We present the case of a 71-year-old female with a history of type 2 diabetes mellitus, hypothyroidism, interstitial cystitis, and osteoarthritis who presented with clinical stage T1N0M0 ER+/PR–/HER2– invasive ductal carcinoma of the lower outer quadrant of the left breast, for which she underwent left segmental mastectomy and sentinel lymph node biopsy followed by completion axillary lymph node dissection. Her final pathologic stage was T1N1M0. RESULT: The patient developed RRD and later RIOP following receipt of radiation and chemotherapy, which resolved with steroid administration. CONCLUSIONS: The rarity of both RRD and RIOP occurring in a patient, as in our case, suggests a shared pathophysiology behind these two complications. As both reactions involve some degree of inflammation and respond to corticosteroids, it seems likely that the etiologies of RRD and RIOP lie within the inflammatory pathway. However, further investigation should evaluate the frequency, duration, and triggering of concomitant RRD and RIOP. S. Karger AG 2020-07-29 /pmc/articles/PMC7443621/ /pubmed/32884534 http://dx.doi.org/10.1159/000508493 Text en Copyright © 2020 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Liu, I-Chia
Giap, Fantine
Mailhot-Vega, Raymond B.
Bradley, Julie A.
Mendenhall, Nancy P.
Okunieff, Paul
Lu, Li
Jantz, Michael A.
Daily, Karen
Spiguel, Lisa
Lockney, Natalie A.
Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title_full Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title_fullStr Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title_full_unstemmed Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title_short Concomitant Radiation Recall Dermatitis and Organizing Pneumonia following Breast Radiotherapy: A Case Report
title_sort concomitant radiation recall dermatitis and organizing pneumonia following breast radiotherapy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443621/
https://www.ncbi.nlm.nih.gov/pubmed/32884534
http://dx.doi.org/10.1159/000508493
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