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A lethal complication after transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma.

Toro A, Bertino G, Arcerito MC, Mannnino M, Ardiri A, Patane' D, Di Carlo I - Case Rep Surg (2015)

Bottom Line: Following the procedure the patient developed a hepatic abscess and biliobronchial fistula resulting in adult respiratory distress syndrome and death.Conclusion.We speculate that DEB-TACE has a prolonged effect on the tumor and the surrounding liver, resulting in progressive enlargement of the necrotic area.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, 95100 Catania, Italy.

ABSTRACT
Background. The current standard of care for patients with large or multinodular noninvasive hepatocellular carcinoma is conventional transarterial chemoembolization (TACE). TACE may also be performed with drug-eluting beads, but serious complications of this procedure have been reported. Methods. Aim of this report is to present a patient affected by multifocal HCC who underwent TACE with drug-eluting bead (DEB-TACE). Results. Following the procedure the patient developed a hepatic abscess and biliobronchial fistula resulting in adult respiratory distress syndrome and death. Conclusion. We speculate that DEB-TACE has a prolonged effect on the tumor and the surrounding liver, resulting in progressive enlargement of the necrotic area. This activity that can extend to the surrounding healthy hepatic tissues may continue indefinitely.

No MeSH data available.


Related in: MedlinePlus

CT scan before presenting to our emergency room with bilioptysis and fever. (a) There is a huge fluid collection adjacent to the dome of the right lobe of the liver. (b) Multiple abscesses are scattered throughout the right lobe of the liver.
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fig3: CT scan before presenting to our emergency room with bilioptysis and fever. (a) There is a huge fluid collection adjacent to the dome of the right lobe of the liver. (b) Multiple abscesses are scattered throughout the right lobe of the liver.

Mentions: The patient was then lost to follow-up for 3 mo before presenting to our emergency room with bilioptysis and fever (39°C). Abdominal CT showed a huge fluid collection (Figure 3(a)) in the right lobe of the liver and a narrow communication between the collection and the thoracic cavity. There were multiple abscesses throughout the right lobe of the liver (Figure 3(b)). A biliobronchial fistula was diagnosed by bronchoscopy. The patient died of adult respiratory distress syndrome 2 wk later.


A lethal complication after transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma.

Toro A, Bertino G, Arcerito MC, Mannnino M, Ardiri A, Patane' D, Di Carlo I - Case Rep Surg (2015)

CT scan before presenting to our emergency room with bilioptysis and fever. (a) There is a huge fluid collection adjacent to the dome of the right lobe of the liver. (b) Multiple abscesses are scattered throughout the right lobe of the liver.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4353438&req=5

fig3: CT scan before presenting to our emergency room with bilioptysis and fever. (a) There is a huge fluid collection adjacent to the dome of the right lobe of the liver. (b) Multiple abscesses are scattered throughout the right lobe of the liver.
Mentions: The patient was then lost to follow-up for 3 mo before presenting to our emergency room with bilioptysis and fever (39°C). Abdominal CT showed a huge fluid collection (Figure 3(a)) in the right lobe of the liver and a narrow communication between the collection and the thoracic cavity. There were multiple abscesses throughout the right lobe of the liver (Figure 3(b)). A biliobronchial fistula was diagnosed by bronchoscopy. The patient died of adult respiratory distress syndrome 2 wk later.

Bottom Line: Following the procedure the patient developed a hepatic abscess and biliobronchial fistula resulting in adult respiratory distress syndrome and death.Conclusion.We speculate that DEB-TACE has a prolonged effect on the tumor and the surrounding liver, resulting in progressive enlargement of the necrotic area.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Cannizzaro Hospital, 95100 Catania, Italy.

ABSTRACT
Background. The current standard of care for patients with large or multinodular noninvasive hepatocellular carcinoma is conventional transarterial chemoembolization (TACE). TACE may also be performed with drug-eluting beads, but serious complications of this procedure have been reported. Methods. Aim of this report is to present a patient affected by multifocal HCC who underwent TACE with drug-eluting bead (DEB-TACE). Results. Following the procedure the patient developed a hepatic abscess and biliobronchial fistula resulting in adult respiratory distress syndrome and death. Conclusion. We speculate that DEB-TACE has a prolonged effect on the tumor and the surrounding liver, resulting in progressive enlargement of the necrotic area. This activity that can extend to the surrounding healthy hepatic tissues may continue indefinitely.

No MeSH data available.


Related in: MedlinePlus