Drug extravasation: a dreaded complication

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Lung adenocarcinoma is a common malignancy.
• Chemotherapy, including docetaxel, is a standard treatment for advanced lung cancer.
• Extravasation is a known complication of chemotherapy administration.

Purpose of the Study:

• To report a case of delayed and distant docetaxel extravasation.
• To describe the clinical presentation and management of this rare adverse event.
• To highlight the importance of recognizing and treating chemotherapy extravasation.

Main Methods:

• A 62-year-old male patient with stage IV lung adenocarcinoma received chemotherapy with cisplatin and docetaxel.
• The patient presented with symptoms of delayed and distant extravasation 12 days after infusion.
• Physical examination revealed erythema and blisters at the infusion site and surrounding areas.
• Diagnosis of docetaxel extravasation was confirmed.
• Treatment involved normal saline washes, topical hydrocortisone, and antibiotic ointment.

Main Results:

• The patient developed a 9x4.5 cm area of erythema and blisters.
• Symptoms of burning sensation, erythema, and blistering were noted.
• The condition resolved over 6 weeks with conservative treatment.
• The only sequelae were two areas of skin hyperpigmentation.

Conclusions:

• Delayed and distant docetaxel extravasation is a rare but significant adverse event.
• Prompt recognition and conservative management can lead to favorable outcomes.
• Healthcare providers should be vigilant for signs and symptoms of extravasation, even when delayed.