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Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature

A 65-year-old man was treated with a course of rituximab, cisplatin, and cytarabine. During the second cycle, a volume of 40–50 mL of 0.3 mg/mL cisplatin was extravasated. The patient was treated with a cold pack multiple times a day and cutaneous application of dimethyl sulfoxide cream three times...

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Autores principales: Braam, Anouk M., Wondergem, Mariëlle, Crul, Mirjam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9941778/
https://www.ncbi.nlm.nih.gov/pubmed/36825098
http://dx.doi.org/10.1159/000525525
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author Braam, Anouk M.
Wondergem, Mariëlle
Crul, Mirjam
author_facet Braam, Anouk M.
Wondergem, Mariëlle
Crul, Mirjam
author_sort Braam, Anouk M.
collection PubMed
description A 65-year-old man was treated with a course of rituximab, cisplatin, and cytarabine. During the second cycle, a volume of 40–50 mL of 0.3 mg/mL cisplatin was extravasated. The patient was treated with a cold pack multiple times a day and cutaneous application of dimethyl sulfoxide cream three times a day for a week. In the months after the extravasation, the patient suffered from worsened swelling and redness and a black crust had formed on the wound. The patient was diagnosed with chemical phlebitis. After watchful waiting for 3 months, antibiotic therapy was started. After 7 months, the wound had healed. On the contrary to what is described in our case, no extravasation guideline classifies cisplatin in a concentration lower than 0.4 mg/ml as a vesicant. The different guidelines also present conflicting recommendations on how to treat the extravasation of cisplatin. In three previous case reports, severe effects of cisplatin extravasation after infusion at low concentration were described as well. We recommend that the findings from our case report are incorporated into extravasation guidelines to ensure optimal treatment of cisplatin extravasations.
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spelling pubmed-99417782023-02-22 Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature Braam, Anouk M. Wondergem, Mariëlle Crul, Mirjam Case Rep Oncol Case Report A 65-year-old man was treated with a course of rituximab, cisplatin, and cytarabine. During the second cycle, a volume of 40–50 mL of 0.3 mg/mL cisplatin was extravasated. The patient was treated with a cold pack multiple times a day and cutaneous application of dimethyl sulfoxide cream three times a day for a week. In the months after the extravasation, the patient suffered from worsened swelling and redness and a black crust had formed on the wound. The patient was diagnosed with chemical phlebitis. After watchful waiting for 3 months, antibiotic therapy was started. After 7 months, the wound had healed. On the contrary to what is described in our case, no extravasation guideline classifies cisplatin in a concentration lower than 0.4 mg/ml as a vesicant. The different guidelines also present conflicting recommendations on how to treat the extravasation of cisplatin. In three previous case reports, severe effects of cisplatin extravasation after infusion at low concentration were described as well. We recommend that the findings from our case report are incorporated into extravasation guidelines to ensure optimal treatment of cisplatin extravasations. S. Karger AG 2022-10-07 /pmc/articles/PMC9941778/ /pubmed/36825098 http://dx.doi.org/10.1159/000525525 Text en Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Braam, Anouk M.
Wondergem, Mariëlle
Crul, Mirjam
Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title_full Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title_fullStr Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title_full_unstemmed Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title_short Severe Tissue Necrosis after Low-Concentration Cisplatin Extravasation: A Case Report and Review of Expert Guidelines and Literature
title_sort severe tissue necrosis after low-concentration cisplatin extravasation: a case report and review of expert guidelines and literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9941778/
https://www.ncbi.nlm.nih.gov/pubmed/36825098
http://dx.doi.org/10.1159/000525525
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