title: Cutaneous complications of hepatic chemoembolization via extrahepatic collaterals.
abstract: OBJECTIVE
  To report cutaneous complications occurring after chemoembolization of hepatic tumors via extrahepatic collaterals.
  
  
  METHODS
  Five patients underwent chemoembolization via the internal mammary (n = 3), intercostal (n = 1), or multiple extrahepatic collateral vessels supplying liver metastases.
  
  
  RESULTS
  Painful induration and discoloration of the skin in the distribution of the superior epigastric or intercostal arteries occurred in four patients, with transmural necrosis in two. One required surgical excision. One patient developed a radiation burn after 12 procedures and eventually developed a squamous cell carcinoma at the site, which required resection and skin grafting.
  
  
  CONCLUSIONS
  Cutaneous injury can occur after chemoembolization of extrahepatic collaterals. Scrupulous technique is required to avoid nontarget embolization of chemotherapeutic drugs. High cumulative radiation doses to localized areas of skin can occur in patients undergoing multiple procedures.
authors.affiliation: Division of Interventional Radiology, University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: R
authors.initials: R
authors.lastname: Arora
authors.forename: M C
authors.initials: MC
authors.lastname: Soulen
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Haskal
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D000792:Angiography; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D003097:Collateral Circulation; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004338:Drug Combinations; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000556:secondary / Q000628:therapy*; D008323:Mammary Arteries; D009364:Neoplasm Recurrence, Local; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D011142:Polyvinyl Alcohol / Q000008:administration & dosage / Q000009:adverse effects*; D012509:Sarcoma / Q000098:blood supply / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D004338:Drug Combinations; D011142:Polyvinyl Alcohol