PMC3582599_01
The patient underwent radiation therapy for spinal bone metastasis. The spinal compression from the RCC bone metastasis (A). The irradiated region is shown in the horizontal section (B) and the coronal section (C).
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F1
On January, 2012, during the follow-up period, bilateral lower limb paralysis occurred due to spinal compression from RCC bone metastasis (Figure 1A). He underwent radiation therapy on his thoracic vertebrae (Th5-8) with a total dose of 24 Gy that was divided into six fractions (Figure 1B and C).
Radiation recall pneumonitis induced by sunitinib. On the 14th day of sunitinib induction, bilateral lung consolidation appeared (A). During follow-up without sunitinib, consolidation developed along with progressive fever (B). After steroid pulse therapy, the CT findings revealed that the interstitial filtration was localized in the previously irradiated area (C). No evidence of relapse of recall pneumonitis during sorafenib treatment was observed (D).
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F2
On the 14th day of sunitinib treatment, the patient complained of high fever and the chest CT disclosed bilateral lung consolidation (Figure 2A). Although he was observed without sunitinib administration, the patient developed progressive fever with worsening of dyspnea and general weakness (Figure 2B). The radiological findings revealed that the interstitial filtration was localized within the previously irradiated area (Figure 2C). The patient recovered from the interstitial lung disease completely during the 2 months of follow-up (Figure 2D).