Necrotizing myositis in a rectus muscle arising in the setting of long-standing Langerhans cell histiocystosis and recent dabrafenib treatment Journal Article
| Authors: | van Landingham, S. W.; Puccetti, D.; Potter, H.; Gamm, D.; Diamond, E. L.; Lucarelli, M. J. |
| Article Title: | Necrotizing myositis in a rectus muscle arising in the setting of long-standing Langerhans cell histiocystosis and recent dabrafenib treatment |
| Abstract: | Purpose: to describe an unusual case of necrotizing myositis in a rectus muscle, possibly related to BRAF inhibitor therapy. Observations: An 18-year old man with neurodegenerative Langerhans cell histiocytosis (LCH), recently started on the BRAF inhibitor dabrafenib, presented with right eye pain. Magnetic resonance imaging (MRI) orbits revealed a rectus muscle mass concerning for LCH recurrence or malignancy. Dabrafenib was stopped, and incisional biopsy of the mass was performed. The mass was absent on post-operative MRI, so no further treatment was pursued. Histopathologic evaluation was initially concerning for sarcoma, but on further analysis, appeared more consistent with necrotizing myositis. The mass did not recur, nor did the patient develop other signs or symptoms concerning for myositis or malignancy over a 24-month follow-up period. Conclusions: Necrotizing myositis has not been previously described in a rectus muscle or with BRAF inhibitor use, though myalgias and malignancies are established side effects. Necrotizing myositis may masquerade as sarcoma and should be on the differential diagnosis for a new mass in the setting of dabrafenib therapy. © 2020 The Authors |
| Keywords: | adult; clinical article; human tissue; young adult; prednisone; histopathology; case report; cytarabine; rituximab; nuclear magnetic resonance imaging; follow up; differential diagnosis; steroid; vincristine; vinblastine; sarcoma; pentoxifylline; emollient agent; headache; hypothyroidism; disease exacerbation; blurred vision; mercaptopurine; eye pain; external ear; langerhans cell histiocytosis; corticotropin deficiency; hypopituitarism; myositis; mass; diabetes insipidus; dabrafenib; braf inhibitor; high throughput sequencing; muscle mass; afferent pupillary defect; human; male; article; b-raf inhibitor; necrotizing myopathy; necrotizing myositis; orbital myositis; rectus muscle; lateral rectus muscle; naturopathy; zygoma |
| Journal Title: | American Journal of Ophthalmology Case Reports |
| Volume: | 20 |
| ISSN: | 2451-9936 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2020-12-01 |
| Start Page: | 100868 |
| Language: | English |
| DOI: | 10.1016/j.ajoc.2020.100868 |
| PROVIDER: | scopus |
| PMCID: | PMC7452147 |
| PUBMED: | 32875153 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2020 -- Source: Scopus |
