melphalan and Muscular-Diseases

We report the case of a 15-month-old boy with retinoblastoma who developed exotropia secondary to a right medial rectus infarct after intra-arterial chemotherapy. He had unilateral sporadic group C tumor (International Classification of Retinoblastoma) and was treated with intra-arterial melphalan. One week after the first session of intra-ophthalmic arterial melphalan chemotherapy, he was noted to have orbital congestion, exotropia, and right adduction limitation. Magnetic resonance imaging was suggestive of a right medial rectus infarct. The tumor showed a good response to intra-arterial chemotherapy but the exotropia persisted.

Topics: Antineoplastic Agents, Alkylating; Edema; Exotropia; Fluorescein Angiography; Humans; Infant; Infarction; Infusions, Intra-Arterial; Ischemia; Magnetic Resonance Imaging; Male; Melphalan; Muscular Diseases; Oculomotor Muscles; Ophthalmic Artery; Papilledema; Radiography; Retinal Neoplasms; Retinoblastoma

At age of 57 years, a man experienced an episode of rhabdomyolysis. On that occasion muscle biopsy was not performed, however monoclonal gammopathy of undetermined significance (MGUS) was diagnosed. Further he developed a moderate proximal muscle weakness with CK level persistently elevated (1000-1200U/l). When he came to our observation, at age 67, a muscle biopsy revealed an amyloid myopathy and multiple myeloma was at the same time disclosed. Terminal complement complex C5b9 (membrane attack complex) deposits were found in the vessel walls and muscle fibers surface depicted by amyloid. Our case suggests to keep in mind the possibility that amyloid myopathy may begin as an isolate episode of rhabdomyolysis. The detection of complement complex C5b9 suggests that complement cascade is implicated in the muscular damage of amyloid myopathy.

Topics: Aged; Amyloidosis; Betamethasone; Biopsy; Blood Vessels; Complement Membrane Attack Complex; Complement System Proteins; Creatine Kinase; Glucocorticoids; Humans; Male; Melphalan; Muscle Weakness; Muscle, Skeletal; Muscular Diseases; Myeloablative Agonists; Rhabdomyolysis; Treatment Outcome

Topics: Aged; Amyloidosis; Antineoplastic Agents, Alkylating; Drug Therapy, Combination; Fatal Outcome; Humans; Male; Melphalan; Multiple Myeloma; Muscle, Skeletal; Muscular Diseases; Prednisolone

Topics: Burns; Chemotherapy, Cancer, Regional Perfusion; Edema; Extremities; Fasciotomy; Humans; Melphalan; Muscular Diseases; Neoplasms; Paralysis; Peripheral Nervous System Diseases; Temperature

Topics: Aged; Blood Protein Electrophoresis; Follow-Up Studies; Hand; Humans; Immunoelectrophoresis; Leg; Male; Melphalan; Muscular Diseases; Neurologic Manifestations; Paresthesia; Peripheral Nervous System Diseases; Sensation; Waldenstrom Macroglobulinemia