Clinical and Molecular Hepatology  2012;18(3):316-320

doi:10.3350/cmh.2012.18.3.316

Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma.

Sang Jung PARK 1 ; Chang Ha KIM ; Jin Dong KIM ; Soon Ho UM ; Sun Young YIM ; Min Ho SEO ; Dae In LEE ; Jun Hyuk KANG ; Bora KEUM ; Yong Sik KIM

Affiliations

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Keywords

Hepatocellular carcinoma; TACE; Costal metastasis; Paraplegia

Country

Republic of Korea

Language

English

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.