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Radiation Dermatitis following Radioembolization for Hepatocellular Carcinoma: A Case for Prophylactic Embolization of a Patent Falciform Artery

https://doi.org/10.1016/j.jvir.2009.03.011Get rights and content

The most common use of radioembolization is in the treatment of primary and secondary liver tumors, and the most common radioisotope used is yttrium-90. This form of therapy has been proven to be successful in achieving tumor reduction and prolonging survival. Adverse events, although uncommon and usually self-limiting, have been reported. The present report describes a case of radiation dermatitis caused by shunting of 90Y microspheres to the anterior abdominal wall via a patent falciform artery. When identified, prophylactic embolization of this patent artery may prevent the potential adverse event of radiation-induced dermatitis after radioembolization.

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Discussion

We describe a case of 90Y-induced anterior abdominal wall radiation dermatitis via a patent falciform artery. Embolization of chemoembolic agents into the terminal capillaries of the falciform artery have been described in the literature, resulting in a similar development of supraumbilical skin rash, epigastric pain, and skin necrosis (10). Failure to embolize this artery may also result in extrahepatic accumulation of 99mTc macroaggregated albumin in the anterior abdominal wall (11).

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    Citation Excerpt :

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None of the authors have identified a conflict of interest.

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