Skin and soft tissue disorders caused by trabectedin extravasation: A case report.

Abstract

Trabectedin extravasation can cause significant soft tissue disorders. Early surgical intervention has been recommended in the event of chemotherapeutic extravasation; however, treatment tends to remain conservative. Trabectedin is a vesicant drug that is associated with a risk of delayed tissue damage; therefore, leaks should be promptly stopped. Complications associated with central venous (CV) ports include infection, catheter damage and obstruction, which can lead to trabectedin extravasation. In the present case report, a 61-year-old woman who received trabectedin treatment for multiple liver and lung metastases is described. Extravasation developed from a CV port in the right chest during the third course of treatment and swelling was the only apparent symptom at that time. Trabectedin was immediately discontinued and she was administered steroids subcutaneously. Erythema, induration and tenderness appeared on day 1 after extravasation, but skin symptoms were not subsequently exacerbated. The central region of the erythema became crusted ~1 month after extravasation. When the skin condition had settled at 2 months post-extravasation, the patient underwent port removal, debridement and port reattachment.