Abstract
On March 25, 2002, a 63-year-old male with a medical history of hepatocellular carcinoma developed on liver cirrhosis by hepatitis C, and partial hepatectomy (S8 region, performed 3years ago) followed by repeated transcatheter arterial chemotherapy for intrahepatic recurrence of the tumor, was injected with a mixture of lipiodol, mitomycin and farmorubicin through the 10th intercostal artery that fed the hepatic tumor. He experienced pain in the right dorsolateral area of the back the next day, and developed strongly infiltrative and indurative erythema at the painful site 3 days after the treatment. Pathology showed partial necrosis of keratinocytes and appendages, embolization of small vessels, perivascular edema, infiltration of neutrophils around the vessels, and extravasation of erythrocytes. There was no degeneration or necrosis of collagen fiber. Acrinol packing was performed for dermatitis and inflammation gradually disappeared 3 weeks after transcatheter arterial chemotherapy, leaving pigmentation, sclerosis and an intractable ulcer. Injury of the epidermis and vessels was considered due to the cytotoxic effect of the anti-cancer drug and the ischemic effect of lipiodol.
