[A case of spinal infarction related to hepatic arterial infusion chemotherapy].
A 65-year-old male underwent iliocecal excision and hepatic posterior segmentectomy for cecum cancer and synchronous liver hepatic metastasis in September and October 2001, respectively. A reservoir was implanted by the GDA-coil method from the right femoral artery in November, and WHF (5-FU 1,000 mg/m2) was administered 8 times. Because of the remnant liver recurrence, WHF was restarted in April 2002. Left leg paralysis appeared suddenly after the 3rd administration. Heparin and urokinase were administrated continuously after hospitalization. Also, liver function tests showed a worsening condition. The bile duct necrosis in the liver was examined with abdominal CT scan. The anti-coagulation therapy was changed to an oral drug on the 7th day after hospitalization. The liver function tests normalized gradually. Although the rehabilitation for leg paralysis performed during hospitalization was continued after discharge from the hospital, the patient is unable to walk and uses a wheelchair. Hepatic arterial infusion chemotherapy is considered safe for blood and non-blood toxicity compared with systemic chemotherapy. However, there are also complications as in this case, where QOL is reduced remarkably, and caution is required.
Shimizu
Junzo
J
Dept. of Surgery, Sakai Municipal Hospital.
Masutani
Seizo
S
Ishida
Hideyuki
H
Kishi
Kentaro
K
Nakayama
Takahiro
T
Imamura
Hiroshi
H
Tatsuta
Masayuki
M
Furukawa
Hiroshi
H
Yura
Mamoru
M
Saeki
Naoya
N
Kitamura
Shinji
S
Tomotsu
Kouichi
K
Takamura
Manabu
M
Inoue
Yutaka
Y
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002430:Cecal Neoplasms / Q000473:pathology / Q000601:surgery; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects*; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007238:Infarction / Q000139:chemically induced*; D015918:Infusion Pumps, Implantable; D007261:Infusions, Intra-Arterial; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D013131:Spine / Q000098:blood supply*
D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin