Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor that has been associated with EWSR1-CREB1 gene fusion. Outcome in patients with unresectable distant metastases is generally fatal. Interleukin-6 (IL-6) secretion has been described in tumors with EWSR1-CREB1 fusion, and may promote tumor growth due to autocrine stimulation. Tocilizumab is an IL-6 receptor antibody that has potential benefit as a targeted therapy in refractory neoplasms with IL-6 secretion. We describe a child with metastatic AFH with EWSR1-CREB1 fusion and elevated IL-6 whose disease progressed during treatment with traditional chemotherapeutic agents, but improved after targeted therapy with tocilizumab.
Radiation recall reaction is an acute inflammatory response evident in previously irradiated fields, induced by chemotherapy administration. Sixteen-year-old female with relapsed nasopharyngeal carcinoma was treated with gemcitabine and oxaliplatin. Disease remission was observed after four cycles. After the seventh cycle, patient developed acute pain and swelling involving the neck muscles. The affected muscles were within the previous irradiation field. Her symptoms improved with corticosteroid treatment. In contrast to other chemotherapy agents, gemcitabine can induce recall reaction involving deeper tissues. Gemcitabine therapy should be discontinued in the event of a radiation recall, as subsequent exposure will likely exacerbate symptoms.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.