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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Rash and subcutaneous fat necrosis after DEB-TACE with doxorubicin
  1. Ahmed Gamal Elsayed1,
  2. James M Martin2,
  3. Toni Pacioles3
  1. 1Department of Hematology/Oncology, Edwards Comprehensive Cancer Center, Huntington, West Virginia, USA
  2. 2Interventional radiology, Radiology Inc, Huntington, West Virginia, USA
  3. 3Department of Hematology/Oncology, Edwards Comprehensive Cancer Center, Huntington, West Virginia, USA
  1. Correspondence to Dr Ahmed Gamal Elsayed, elsayed{at}marshall.edu

Summary

A 73-year-old woman with hepatocellular carcinoma localised to the liver was treated with doxorubicin-loaded drug-eluting beads through transcatheter arterial chemoembolisation (DEB-TACE). She developed subcutaneous, erythematous, tender nodules in her abdomen 3 days after the procedure. PET/CT scan that was done to evaluate for evidence of disease progression showed mild avidity of these nodules. Biopsy showed fatty necrosis. Nodules started to improve spontaneously 2 weeks after onset. At 8 weeks after onset, lesions stabilised in size and the associated tenderness and erythema resolved. This represents a rare side effect of TACE procedure in general. It can happen secondary to non-target embolisation of hepatic falciform artery, planned embolisation of extrahepatic collateral supplies and even when there is no clear cause. Spontaneous resolution of acute symptoms usually occurs over the course of few weeks, though subcutaneous lesions consisting of necrotic fat tissue may persist for longer periods.

  • cancer intervention
  • hepatic cancer

https://doi.org/10.1136/bcr-2017-222394

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    Footnotes

    • Contributors AGE: prepared the initial draft for the case report, revised the manuscript critically, approved the version to be published and agreed to be accountable for all aspects of the work. TP: revised the manuscript critically, provided some additions and suggestions for many changes, approved the version to be published and agreed to be accountable for all aspects of the work. JMM: provided some pictures with captions, reviewed procedures images retrospectively, revised the manuscript critically, approved the version to be published and agreed to be accountable for all aspects of the work.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.