Yonsei Med J.  2001 Feb;42(1):137-141. 10.3349/ymj.2001.42.1.137.

An ischemic skin lesion after chemoembolization of the right internal mammary artery in a patient with hepatocellular carcinoma

• Lee JH
• Chon CY
• Ahn SH
• Moon BS
• Kim JH
• Paik YH
• Han KH
• Lee JT
• Lee DY
• Moon YM

• KMID: 720598
• DOI: http://doi.org/10.3349/ymj.2001.42.1.137

Abstract

A huge nodular hepatocellular carcinoma located at the anterior superior portion of the left lobe in a patient with hepatocellular carcinoma was treated with transcatheter arterial chemoembolization through the left hepatic artery. Three months later, however, there was a re-elevation of the serum alpha-fetoprotein level and evidence of a marginal recurrence at the left side of the previously embolized tumor was noted on the postembolization computed tomographic scan. Although the hepatic artery was intact in the second hepatic arteriography, we found that the right internal mammary artery was feeding the recurred hepatocellular carcinoma. This internal mammary artery was successfully treated with Lipiodol-transcatheter arterial chemoembolization. However, an ischemic lesion occurred in the skin of the anterior chest and abdominal wall several days after internal mammary artery embolization. We report here a very rare case of ischemic skin lesion on the anterior chest and abdominal wall following transcatheter arterial chemoembolization of the right internal mammary artery. This internal mammary artery was embolized because it had developed a collateral tumor feeding vessel following the initial chemoembolization of a hepatocellular carcinoma.

Keyword

Hepatocellular carcinoma; internal mammary artery; transcatheter arterial chemoembolization; collateral; complication

MeSH Terms

Carcinoma, Hepatocellular/therapy*
Case Report
Chemoembolization, Therapeutic/adverse effects*
Female
Human
Ischemia/etiology*
Liver Neoplasms/therapy*
Mammary Arteries*
Middle Age
Skin/blood supply*