Fat embolism syndrome complicating intraarterial chemotherapy with cis-platinum.
A 19-year-old man with telangiectatic osteosarcoma of the left proximal femur was started on a course of neoadjuvant chemotherapy consisting of intraarterial administration of cis-platinum. Within 72 hours of receiving the first intraarterial dose, the patient developed signs and symptoms of fat embolism syndrome (FES). A physical examination revealed cyanosis, tachycardia, and seizure activity. Laboratory studies demonstrated a pO2 of less than 65 mmHg, lipuria, and a drop in hematocrit of three percentage points. There was no clinical or roentgenographic evidence of pathologic fracture. Tumor necrosis secondary to intraarterial cis-platinum therapy in this patient with osteosarcoma may have caused a sudden release of free fatty acids and embolization of fat macroglobules that precipitated this episode of FES. FES in association with the intraarterial administration of cis-platinum seems not to have been previously reported.
Menendez
L R
LR
Department of Orthopaedics, University of Southern California, Los Angeles.
Bacon
W
W
Kempf
R A
RA
Moore
T M
TM
D000328:Adult; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D004620:Embolism, Fat / Q000209:etiology*; D005266:Femoral Neoplasms / Q000188:drug therapy*; D006801:Humans; D007260:Infusion Pumps; D007269:Injections, Intra-Arterial; D008297:Male; D012516:Osteosarcoma / Q000188:drug therapy*; D013577:Syndrome
D002945:Cisplatin