Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma
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Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained. (Clin Mol Hepatol 2012;18:316-320)
Abstract
Transcatheter arterial chemoembolization (TACE) has been used widely to treat patients with unresectable hepatocellular carcinoma. However, this method can induce various adverse events caused by necrosis of the tumor itself or damage to nontumor tissues. In particular, neurologic side effects such as cerebral infarction and paraplegia, although rare, may cause severe sequelae and permanent disability. Detailed information regarding the treatment process and prognosis associated with this procedure is not yet available. We experienced a case of paraplegia that occurred after conducting TACE through the intercostal artery to treat hepatocellular carcinoma that had metastasized to the rib. In this case, TACE was attempted to relieve severe bone pain, which had persisted even after palliative radiotherapy. A sudden impairment of sensory and motor functions after TACE developed in the trunk below the level of the sternum and in both lower extremities. The patient subsequently received steroid pulse therapy along with supportive care and continuous rehabilitation. At the time of discharge the patient had recovered sufficiently to enable him to walk by himself, although some paresthesia and spasticity remained. (Clin Mol Hepatol 2012;18:316-320)
참고문헌 (12)
- Parkin DM, "Global cancer statistics in the year 2000", Lancet Oncol, 2, pp.533~543 (2001)
- Bruix J, "Prognostic prediction and treatment strategy in hepatocellular carcinoma", Hepatology, 35, pp.519~524 (2002)
- Llovet JM, "Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial", Lancet, 359, pp.1734~1739 (2002)
- Pietrosi G, "Arterial chemoembolization", embolization and early complications after hepatocellular carcinoma treatment: a safe standardized protocol in selected patients with Child class A and B cirrhosis, 2009, pp.20, 896~902
- Tufail K, "Paraparesis caused by transarterial chemoembolization: A case report", World J Hepatol, 2, pp.289~291 (2010)
- Chung JW, "Hepatic tumors: predisposing factors for complications of transcatheter oily chemoembolization", Radiology, 198, pp.33~40 (1996)
- Dai H, "Complications of chemoembolization for hepatic neoplasms", Saudi Med J, 28, pp.1208~1212 (2007)
- Kim JH, "Spinal cord injury subsequent to transcatheter arterial chemoembolization in patients with hepatocellular carcinoma", Dig Liver Dis, 42, pp.67~70 (2010)
- Sliwa JA, "Ischemic myelopathy: a review of spinal vasculature and related clinical syndromes", Arch Phys Med Rehabil, 73, pp.365~372 (1992)
- Bowen BC, "MR angiography of normal intradural vessels of the thoracolumbar spine", AJNR Am J Neuroradiol, 17, pp.483~494 (1996)
- Gillilan LA, "The arterial blood supply of the human spinal cord", J Comp Neurol, 110, pp.75~103 (1958)
- Sturzenegger M, "Spinal stroke syndomes, In Stroke Syndromes. 2nd ed", pp.691~704 (2001), Cambridge Univ Pr