An ischemic skin lesion after chemoembolization of the right internal mammary artery in a patient with hepatocellular carcinoma

A huge nodular hepatocellular carcinoma located at the anterior superior po rtion of the left lobe in a patient with hepatocellular carcinoma was treat ed with transcatheter arterial chemoembolization through the left hepatic a rtery. Three months later, however, there was a re-elevation of the serum a lpha-fetoprotein level and evidence of a marginal recurrence at the left si de of the previously embolized tumor was noted on the postembolization comp uted 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. This internal mammary arter y was successfully treated with Lipiodoltranscatheter arterial chemoemboliz ation. However, an ischemic lesion occurred in the skin of the anterior che st and abdominal wall several days after internal mammary artery embolizati on. We report here a very rare case of ischemic skin lesion on the anterior chest and abdominal wall following transcatheter arterial chemoembolizatio n of the right internal mammary artery. This internal mammary artery was em bolized because it had developed a collateral tumor feeding vessel followin g the initial chemoembolization of a hepatocellular carcinoma.