Surgical management of a hand extravasation of anthracycline at late presentation
Abstract
Anthracycline extravasation remains a feared serious complication of chemotherapy. At late presentation, deep ulceration and extensive soft tissue damage are seen. Hand extravasation of anthracycline may lead to tendon and nerves destruction with functional and economical impairments. We report a case of Epirubicin extravasation seen at day 25 in a 46-year-old woman treated for breast cancer. A groin flap failed due to the persistence of anthracyclin in the wound. A split thickness skin graft was done after all the tendons were removed. The chemotherapy was interrupted for two months. Wide serial debridements are needed to achieve the removal of all molecules of anthracycline that are observed when granulating tissue is observed permanently in the wound.
Copyright (c) 2019 Amouzou KS, et al.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Langer SW, Sehested M, Jensen PB. Anthracycline extravasation: A comprehensive review of experimental and clinical treatments. Tumori 2009; 95(3): 273–282.
Langer SW. Dexrazoxane for the treatment of chemotherapy related side effects. Cancer Manag Res 2014; 6: 357–363. doi: 10.2147/CMAR.S47238.
Dinoi GL, Saibene G, Re B, Balzarini A, et. al. Cytotoxic extravasation: An issue disappearing or a problem without solution? Tumori 2016; 102(3): 290–293. doi: 10.5301/tj.5000486.
Arroyo PA, Perez RU, Feijoo MAF, Hernandez MAC. Good clinical and cost outcomes using dexrazoxane to treat accidental epirubicin extravasation. J Can Res Ther 2010; 6(4): 573– 574. doi: 10.4103/0973-1482.77081.
Kreidieh FY, Moukadem HA, El Saghir NS. Overview, prevention and management of chemotherapy extravasation. World J Clin Oncol 2016; 7(1): 87–97. doi: 10.53 06/wjco.v7.i1.87.
Schrijvers DL. Extravasation: A dreaded complicati- on of chemotherapy. Ann Oncol 2003; 14(3): 26–30. doi: 10.1093/annonc/mdg744.
Dahlstrom KK, Chenoufi HL, Daugaard S. Fluorescence
microscopic demonstration and demarcation of
doxorubicin extravasation experimental and clinical
studies. Cancer 2006; 65(8): 1722–1726. doi: 10.10
/1097-0142(19900415)65:8<1722::AID-CNCR282065
>3.0.CO;2-E.