title: Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: an autopsy case report.
abstract: We report an extremely rare case of pulmonary lipiodol embolism with acute respiratory distress syndrome (ARDS) after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). A 77-year-old man who was diagnosed with a huge HCC was admitted for TACE. Immediately after the procedure, this patient experienced severe dyspnea. We suspected that his symptoms were associated with a pulmonary lipiodol embolism after TACE, and we began intensive treatment. However, his condition did not improve, and he died on the following day. A subsequent autopsy revealed that the cause of death was ARDS due to pulmonary lipiodol embolism. No cases have been previously reported for which an autopsy was performed to explain the most probable mechanism of pulmonary lipiodol embolism; thus, ours is the first report for such a rare case.
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Keiichi
authors: K
authors: Hatamaru
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Shunjiro
authors: S
authors: Azuma
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Takuji
authors: T
authors: Akamatsu
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Takeshi
authors: T
authors: Seta
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Shunji
authors: S
authors: Urai
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Yoshito
authors: Y
authors: Uenoyama
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Yukitaka
authors: Y
authors: Yamashita
authors: Keiichi Hatamaru, Shunjiro Azuma, Takuji Akamatsu, Takeshi Seta, Shunji Urai, Yoshito Uenoyama, Yukitaka Yamashita, Department of Gastroenterology and Hepatology, Japan Red Cross Society Wakayama Medical Center, Wakayama 640-8558, Japan.
authors: Kazuo
authors: K
authors: Ono
mesh_terms: D000368:Aged; D001344:Autopsy; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004998:Ethiodized Oil / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012128:Respiratory Distress Syndrome / Q000209:etiology; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D004998:Ethiodized Oil
keywords: Acute respiratory distress syndrome; Autopsy; Hepatocellular carcinoma; Pulmonary lipiodol embolism; Transcatheter arterial chemoembolization
references: J Vasc Interv Radiol. 2007 Mar;18(3):377-82
references: 17377183
references: Clin Sci (Lond). 2007 Sep;113(6):279-85
references: 17428199
references: J Trauma. 2008 Feb;64(2):462-9
references: 18301216
references: J Pediatr Surg. 2005 Oct;40(10):1647-50
references: 16227000
references: Eur J Anaesthesiol. 2000 Nov;17(11):704-8
references: 11029570
references: J Vasc Interv Radiol. 2002 Sep;13(9 Pt 1):893-900
references: 12354823
references: Eur J Radiol. 2006 Sep;59(3):407-12
references: 16621394
references: Am Rev Respir Dis. 1980 Oct;122(4):543-9
references: 6254413
references: Radiology. 1993 Jun;187(3):689-93
references: 8388567
references: Ann Intern Med. 1995 Apr 1;122(7):521-9
references: 7872588
references: J Nucl Med. 1997 Aug;38(8):1201-5
references: 9255149
references: Eur J Cancer Care (Engl). 2005 Dec;14(5):440-2
references: 16274465
references: Am J Roentgenol Radium Ther Nucl Med. 1966 Apr;96(4):972-8
references: 4286920