Spinal Cord Infarction Following Transarterial Chemoembolization of Hepatocellular Carcinoma with Chest Wall Metastasis: A Case Report and Review of the Literature
Kulsatree Praditukrit¹, Jiraporn Jitprapaikulsan¹, Somrach Thamtorawat², Somchai Limsrichamrern³, Weerawat Saengphatrachai¹
Affiliation : ¹ Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; ² Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; ³ Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Spinal cord infarction (SCI) is a rare but detrimental complication following transarterial chemoembolization (TACE). The case report presented a case of hepatocellular carcinoma (HCC) involving the lateral chest wall for which the patient underwent TACE, targeted at the right ninth intercostal artery. After the intervention, the patient fully developed complete spinal cord syndrome immediately after TACE. Magnetic resonance images of the spinal cord showed abnormal hyperintense lesions on T2-weighted images involving the anterior and central part of the 9th to 11th thoracic spinal cord, compatible with SCI. Although corticosteroids were not administered, the patient’s condition subsequently improved, being capable of walking with a gait aid. SCI after TACE is a possible disabling adverse event. To prevent this complication, the collateral vessels of the spinal arteries, such as the intercostal arteries, should be avoided. Furthermore, monitoring for the symptoms of SCI, especially in the first 24 hours after the intervention, should also be done in all TACE cases.
Received 16 January 2023 | Revised 1 March 2024 | Accepted 3 March 2024
DOI: 10.35755/jmedassocthai.2024.3.13957
Keywords : Spinal cord injury; Spinal cord infarction; Transarterial chemoembolization; Hepatocellular carcinoma; Case report
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