SEVERE NECROSIS DUE TO PACLITAXEL EXTRAVASATION

Paclitaxel is an antineoplastic agent derived from the bark of the Pac ific yew tree that has activity against many tumors including breast a nd ovarian carcinomas. In the past, its extravasation quality has been considered to be a local irritant; however, recent reports suggest th at the agent may be a vesicant. A patient experienced a delayed vesica nt reaction to a paclitaxel extravasation that resulted in severe necr osis. No acute symptoms were reported at the time of extravasation fro m the 24-hour peripheral paclitaxel infusion. However, on day 11 the p atient complained of severe and progressive pain at the site of extrav asation. The site was erythematous and had areas of central necrosis r equiring debridement and closure by a plastic surgeon. Because paclita xel possesses vesicant characteristics, health care professionals shou ld be aware of its potential extravasation hazard. Prolonged periphera l infusions should be avoided or administered with extreme caution.