Scholarlink

Introduction <p>Spontaneous pyomyositis is an uncommon but serious infectious complication that typically occurs in immunocompromised patients and is more frequently reported in association with haematological malignancies. It’s occurrence in patients with solid organ tumours receiving systemic chemotherapy is rare and to date has not been described in the setting of germ cell tumours.</p> Case Presentation <p>We report the case of a 50-year-old male with metastatic mixed germ cell tumour who developed pyomyositis following completion of four cycles of etoposide and cisplatin chemotherapy. Post-treatment, he developed severe pancytopenia complicated by fever, significant unilateral lower limb pain, and swelling. Initial imaging demonstrated multiple rim-enhancing intramuscular lesions, raising concern for metastatic disease versus abscess formation. Despite normalised tumour markers and no evidence of disease on restaging imaging, the radiological appearance remained equivocal. Image-guided biopsy and aspiration were therefore performed, yielding purulent material that cultured <i>Staphylococcus aureus</i>, with histopathology confirming benign inflammatory changes and no evidence of malignancy. The patient was successfully treated with oral antibiotics, with complete radiological resolution of lesions and no evidence of tumour relapse on follow-up.</p> Conclusion <p>This case represents, to our knowledge, the first reported instance of pyomyositis occurring in a patient with metastatic mixed germ cell tumour following chemotherapy. It highlights the importance of considering pyomyositis and spontaneous intramuscular haematoma as differential diagnoses in patients presenting with painful limb swelling in the setting of chemotherapy-induced pancytopenia, and underscores the diagnostic challenges in distinguishing infection from metastatic disease.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Case Report: Pyomyositis in the Setting of Chemotherapy-Induced Pancytopenia: A Rare Complication of Germ Cell Tumour Treatment

  • 期刊论文

  • 发表日期：

    2026年4月1日

查看全文
  • Kaitlyn Trompert-Thompson,
  • Amy Smith,
  • Eugene Ang,
  • Tyrone Soto,
  • Timothy Wade,
  • Amanda Stevanovic

摘要

Introduction

Spontaneous pyomyositis is an uncommon but serious infectious complication that typically occurs in immunocompromised patients and is more frequently reported in association with haematological malignancies. It’s occurrence in patients with solid organ tumours receiving systemic chemotherapy is rare and to date has not been described in the setting of germ cell tumours.

Case Presentation

We report the case of a 50-year-old male with metastatic mixed germ cell tumour who developed pyomyositis following completion of four cycles of etoposide and cisplatin chemotherapy. Post-treatment, he developed severe pancytopenia complicated by fever, significant unilateral lower limb pain, and swelling. Initial imaging demonstrated multiple rim-enhancing intramuscular lesions, raising concern for metastatic disease versus abscess formation. Despite normalised tumour markers and no evidence of disease on restaging imaging, the radiological appearance remained equivocal. Image-guided biopsy and aspiration were therefore performed, yielding purulent material that cultured Staphylococcus aureus, with histopathology confirming benign inflammatory changes and no evidence of malignancy. The patient was successfully treated with oral antibiotics, with complete radiological resolution of lesions and no evidence of tumour relapse on follow-up.

Conclusion

This case represents, to our knowledge, the first reported instance of pyomyositis occurring in a patient with metastatic mixed germ cell tumour following chemotherapy. It highlights the importance of considering pyomyositis and spontaneous intramuscular haematoma as differential diagnoses in patients presenting with painful limb swelling in the setting of chemotherapy-induced pancytopenia, and underscores the diagnostic challenges in distinguishing infection from metastatic disease.