Gemcitabine-Induced Radiation Recall Phenomenon in Cervical Cancer: A Case Report

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• Radiation recall is a rare inflammatory response to chemotherapy in previously irradiated tissues.
• It can mimic tumor recurrence, particularly in the pelvis, leading to diagnostic challenges.
• Early identification is crucial to prevent unnecessary interventions and patient harm.

Observation:

• A 47-year-old patient with cervical carcinoma (FIGO stage IIB) received radiotherapy, chemotherapy (cisplatin), and brachytherapy.
• Following surgery and further chemotherapy (cisplatin and gemcitabine), she developed a suspicious vaginal dome mass.
• This mass was diagnosed as an inflammatory reaction, not tumor recurrence.

Findings:

• The patient's presentation mimicked pelvic cancer recurrence after chemoradiation and surgery.
• Histopathological examination revealed an exuberant inflammatory reaction.
• The reaction significantly regressed following corticosteroid therapy.

Implications:

• This case highlights the importance of considering radiation recall in patients with a history of pelvic radiation presenting with suspicious masses.
• Accurate diagnosis prevents aggressive, potentially harmful, and unnecessary surgical interventions.
• Corticosteroids are an effective treatment for radiation recall, resolving symptoms and avoiding complications.