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Supraumbilical Ischemic Skin Lesions as a Rare Complication of Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma

Judith Hambauer1, Roland Noemeyer1, Patrick Dinkhauser1, Peter Spoettl2 and Harald Hofer1*
1Department of Internal Medicine I, Klinikum Wels-Grieskirchen, Austria
2Department of Radiology, Klinikum Wels-Grieskirchen, Austria


*Corresponding author: Harald Hofer, Department of Internal Medicine I, Klinikum Wels-Grieskirchen, Grieskirchner Strasse 42, 4600 Wels, Austria

Published: 11 May, 2018
Cite this article as: Hambauer J, Nomeyer R, Dinkhauser P, Spottl P, Hofer H. Supraumbilical Ischemic Skin Lesions as a Rare Complication of Transarterial Chemoembolization in a Patient with Hepatocellular Carcinoma. Clin Oncol. 2018; 3: 1467.

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We present a case of a 57-years old male patient with a liver cirrhosis (Child A) due to nonalcoholic fatty liver disease (NASH) and an intermediate stage (BCLC-B) Hepatocellular Carcinoma (HCC). The patient underwent 2 Transarterial Chemoembolizations (TACE) before. Now the patient was hospitalized for a third TACE in the left hepatic lobe, which was performed uneventfully with the use of 75 μg drug (doxorubicin) eluting beats (Figure 1A and 1B). Twelve hours later the patient complained about abdominal pain. The clinical examination revealed a distinct supraumbilical rash (Figure 1C). Due to analgetic therapy the abdominal pain suspended and also the rash improved during the following days, but residual lesions still persisted after 50 days (Figure 1D).
The incidental embolization of small skin vessels during TACE of HCC has been described before and communication of skin vessels with the arteria falciformis, as well as associations with the use of very small drug eluting beads have been discussed [1-4].


Figure 1

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Figure 1
Angiographic images of transarterial chemoembolization (TACE) (A,B), skin lesion at day 1 (C) and at day 50 after TACE (D).

References

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  2. E del Alcazar Viladomiu, A Lopez Pestana, A Tuneu Valls, I Prieto Argarate, J Arenas Ruiz Tapiador. Supraumbilical cutaneous lesions after transcatheter arterial chemoembolization for hepatocellular carcinoma. J Am Acad Dermatol. 2014;71(2):49-50.
  3. Baysal T, D Agostino HB, Serra EE, Valji K, Rose SC, Kinney TB. Supraumbilical dermal sclerosis and fat necrosis from chemoembolization of hepatocellular carcinoma. J Vasc Interv Radiol. 1998;9(4):645-7.
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