A Case of Docetaxel Induced Myositis and Review of the Literature

Abstract

In phase I and II trials taxane chemotherapeutic agents reported side effects, including myelosuppression, peripheral edema, and fluid retention. With further use of these agents, studies in the late 1980s and early 1990s began to report peripheral neuropathy and proximal muscle weakness as common complaints, the later with unexplained pathophysiology. We report a 65-year-old Hispanic woman with estrogen receptor (ER) and progesterone receptor (PR) positive invasive ductal breast carcinoma who presented with right thigh pain and swelling eight days after her third infusion of docetaxel (a taxane chemotherapeutic) and cyclophosphamide. Laboratory findings were notable for elevation in creatine phosphokinase (CPK), aldolase, and erythrocyte sedimentation rate (ESR); a magnetic resonance imaging (MRI) of her lower extremities showed evidence of bilateral muscle edema involving the anterior compartment muscles of the thighs. A workup to rule out other causes of myositis was negative. Docetaxel was not reintroduced and the patient improved with corticosteroids. Since 2005 this is, to our knowledge, the fifth reported case of docetaxel related inflammatory myositis. Taxanes have been noted to cause disabling but transient arthralgias and myalgias; it is important to consider the possibility of inflammatory myopathy as a possible complication in patients undergoing treatment with these agents.

Gemcitabine/nab‐paclitaxel for pediatric relapsed/refractory sarcomas

“…Grade 3 myositis occurred in two cycles in two different patients, neither of which were associated with radiation. Myositis has previously been reported with taxanes (though not with nab‐paclitaxel) and gemcitabine . Both episodes resolved within 1 week with oral dexamethasone therapy and both were able to continue gemcitabine/nab‐paclitaxel without dose modifications once the dexamethasone was discontinued.…”

Complete response to pembrolizumab in a patient with dermatomyositis and MMR deficient ovarian cancer: A case report

“…In addition to a paraneoplastic syndrome, providers should be aware of other causes of myositis in patients with malignancy. Case reports and studies have described taxane medications inducing transient myositis in patients ( Perel-Winkler et al, 2015 ). Discontinuing the taxane chemotherapy and treatment with corticosteroids, is associated with improvement ( Bohan et al, 1977 , Perel-Winkler et al, 2015 ).…”

Paraneoplastic Necrotizing Myopathy Post Lumpectomy and Chemotherapy for Early Breast Cancer

“…In all previously reported cases, a temporal relationship with treatment along with elevated CK and muscle weakness was considered sufficient for diagnosis. No biopsy reports were available for these cases [6]. We ruled out chemotherapy-induced myopathy based on the gross elevations in CK, characteristic of IMNM, and the conclusive muscle biopsy report.…”