[A case of epidural abscess occurred after liver abscess complicated by transarterial chemoembolization in a patient with metastatic cancer to liver]

Korean J Gastroenterol. 2013 Apr;61(4):225-9. doi: 10.4166/kjg.2013.61.4.225.
[Article in Korean]

Abstract

Transarterial chemoembolization (TACE) is one of the most effective therapies for unresectable hepatocelluar carcinoma or metastatic hypervascular tumors. Abscess occurring in the other organs beside the liver after TACE is a complication that often occurs, sometimes potentially fatal. We report a case of spinal epidural abscess occurred after liver abscess complicated by TACE in a patient with metastatic neuroendocrine tumors to the liver. A 67-year-old female underwent TACE first for the metastatic lesions to liver, with a history of pancreatoduodenectomy for the primary pancreatic neuroendocrine tumor. Four days after TACE, sudden high fever occurred, and liver abscess was found on abdominal CT. Two days later, back pain and radiating pain to the right leg occurred, and lumbar spine MRI showed spinal epidural abscess. After intravenous antibiotics for 8 weeks and partial laminectomy, the patient recovered and was discharged without complications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Carcinoma, Hepatocellular / secondary
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / adverse effects*
  • Epidural Abscess / etiology*
  • Epidural Abscess / microbiology
  • Epidural Abscess / surgery
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy
  • Female
  • Humans
  • Laminectomy
  • Liver Abscess / etiology*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / microbiology
  • Magnetic Resonance Imaging
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / surgery
  • Pancreaticoduodenectomy
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents