Severe rhabdomyolysis associated with etoposide-nedaplatin chemotherapy in a patient with small cell lung cancer：case report and review of literature

Etoposide combined with platinum drugs is the first-line chemotherapy for small cell lung cancer（SCLC）. Here, we describe the first case with small cell lung cancer, who developed severe rhabdomyolysis after etoposide-nedaplatin chemotherapy. He complained of progressive generalized muscle pain and weakness after first cycle chemotherapy for SCLC, accompanied by elevated creatine kinase (CK), myoglobin (Mb), alanine aminotransferase (ALT), spartate aminotransferase (AST) and lactate dehydrogenase (LDH). Examination and inquiry of medical history were used to exclude the factors of rhabdomyolysis caused by trauma, strenuous activities, infections, hyperthermia and immunity, the patient was diagnosed with severe rhabdomyolysis induced by chemotherapy. After treatment with intravenous fluids and methylprednisolone, the patient’s symptoms were relieved and laboratory tests were significantly improved. An unexpected situation is that the lung CT scan showed that the lung mass was significantly smaller than that before chemotherapy, but the reason is not clear. Rhabdomyolysis induced by anti-cancer drugs, especially chemotherapy drugs, is rarely reported and easily overlooked. Therefore, physicians should be aware of this rare but potentially serious complication when using chemotherapy drugs.