Abstract

A large nodular hepatocellular carcinoma located at the anterior superior portion of the left lobe was treated with transcatheter arterial chemoembolization through the left hepatic artery. Three months later, however, there was a re-elevation of the serum alpha-fetoprotein level and an evidence of a marginal recurrence at the left side of the previously embolized tumor was noted on the postembolizeation computed tomographic scan. Although the hepatic artery was intact in the second hepatic arteriography, we found that the right internal mammary artery was feeding the recurred hepatocellular carcinoma. Right internal mammary artery was successfully treated with Lipiodol-transcatheter arterial chemoembolization. However, an ischemic lesion occurred in the skin of the anterior chest and abdominal wall several days after the embolization of the internal mammary artery. We report here a very rare case of ischemic skin lesion on the anterior chest and abdominal wall following transcatheter arterial chemoembolization of the right internal mammary artery. This internal mammary artery was embolized because it had developed a collateral tumor feeding vessel following the initial chemoembolization of a hepatocellular carcinoma.

• Keywords: Hepatocellular carcinoma;Internal mammary artery;Transcatheter arterial chemoembolization;Collateral;Complication