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CASE REPORTS  
CMH 2012 September;18:316-320.
Published online 2012 September 26. doi:http://dx.doi.org/10.3350/cmh.2012.18.3.316
Copyright © 2012 The Korean Association for the Study of the Liver
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Spinal cord injury after conducting transcatheter arterial chemoembolization for costal metastasis of hepatocellular carcinoma
Sang Jung Park, Chang Ha Kim, Jin Dong Kim, Soon Ho Um, Sun Young Yim, Min Ho Seo, Dae In Lee, Jun Hyuk Kang, Bora Keum, and Yong Sik Kim
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Chang Ha Kim ,Tel: +82-2-953-1943, Fax: +82-2-920-6608, Email: drkimch@naver.com
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.
Keywords: Hepatocellular carcinoma; TACE; Costal metastasis; Paraplegia
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