Soft-tissue complications of intra-arterial chemotherapy for extremity XXXX .

@entity632 @entity1 @entity2828 @entity511 @entity66 @entity242 @entity1261 @entity5 @entity39 @entity900 @entity10049 @entity1352 @entity1129 @entity158 @entity291
High-grade @entity242 have a high rate of local recurrence as well as distant metastases. This has led to the development of intra-arterial chemotherapy (IAC) as part of a multimodal approach to control @entity66 and/or reduce the extent of surgical resection. Intra-arterial catheters are positioned by an interventional radiologist into the feeding vessels of the @entity5 . @entity632 and @entity10049 are infused intra-arterially. @entity900 , with or without @entity1261 , is given systemically. @entity1 usually experience acute self-limited soft-tissue inflammation in the treated area. In our experience of 118 @entity1 , 3 @entity1 experienced soft-tissue @entity39 that required excision and reconstruction. The first was treated for @entity1352 of a metatarsal. After IAC with @entity632 , she sloughed the skin, subcutaneous tissue, and some of the posterior compartment musculature of her @entity291 . This tissue was debrided. @entity1129 and skin graft were used for coverage. She is free of disease and ambulatory. The second @entity1 was treated with IAC @entity632 for a radial head @entity511 . She developed soft-tissue slough, which became infected with Pseudomonas. She required extensive debridement of the skin, subcutaneous tissue, and muscle, and was subsequently reconstructed with a latissimus flap and a split-thickness skin graft (STSG). She later developed a local recurrence requiring amputation. The latissimus was elevated and used to cover the distal stump. She also is free of disease. The third @entity1 was treated with IAC @entity632 for @entity2828 of the right femur. This was complicated by fat @entity39 and persistent @entity158 . Subsequent radiotherapy only worsened her symptoms. She underwent wide excision and muscle flap/STSG repair, which relieved her @entity158 . She is currently ambulatory and free of disease. In conclusion, as the use of IAC continues, its complications may become more common. Our experience with this previously unknown entity is illustrated and therapeutic options are discussed.
