Clin Mol Hepatol.  2012 Sep;18(3):316-320. 10.3350/cmh.2012.18.3.316.

Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma

• Park SJ
• Kim CH
• Kim JD
• Um SH
• Yim SY
• Seo MH
• Lee DI
• Kang JH
• Keum B
• Kim YS

• KMID: 1392912
• DOI: http://doi.org/10.3350/cmh.2012.18.3.316

Abstract

Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained.

Keyword

Hepatocellular carcinoma; TACE; Costal metastasis; Paraplegia

MeSH Terms

Antiviral Agents/therapeutic use
Bone Neoplasms/radiography/secondary
Carcinoma, Hepatocellular/diagnosis/pathology/*therapy
Catheter Ablation
Chemoembolization, Therapeutic/*adverse effects
Hepatitis B/complications/drug therapy
Humans
Liver Cirrhosis/etiology
Liver Neoplasms/diagnosis/pathology/*therapy
Male
Middle Aged
Positron-Emission Tomography
Soft Tissue Neoplasms/secondary
Spinal Cord Injuries/*etiology
Tomography, X-Ray Computed