Chemotherapy and extreme exercise: A potentially dangerous combination

Abstract

Acute exertional compartment syndrome of the thighs is extremely rare. It should be considered in patients who present with myalgia and swelling after vigorous exercise. We present a case of a 35-year-old female athlete with breast cancer who had received one cycle of chemotherapy. The patient presented with diffuse myalgias in her thighs after an exercise session. She was diagnosed with chemotherapy induced compartment syndrome of the bilateral thighs with resultant rhabdomyolysis and acute kidney injury. She required continuous venovenous hemodialysis. The patient suffered a cardiac arrest and could not be resuscitated. This case draws attention to the potential myotoxocity of certain chemotherapeutic agents. It also demonstrates acute compartment syndrome as a rare but devastating consequence of extreme physical training associated with certain chemotherapeutic agents. As many of our patients are adopting vigorous exercise routines, it is important for physicians to be aware of acute exertional compartment syndrome, as it necessitates a high degree of clinical suspicion.