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Skin necrosis following hyperthermic intraperitoneal chemotherapy (HIPEC) with mitomycin C
Emerik Arseneault-Monette1, Kadhim Taqi1, Lloyd Mack1
1Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
BMJ Case Reports
|January 6, 2026
Summary
A rare complication of hyperthermic intraperitoneal chemotherapy (HIPEC) caused cytotoxic skin injury. This case report details a patient who developed a painful rash after HIPEC treatment for colon cancer.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Colon cancer with peritoneal metastasis presents a complex treatment challenge.
- Hyperthermic intraperitoneal chemotherapy (HIPEC) is a critical component in managing advanced cancers.
- Mitomycin C is a chemotherapeutic agent used in HIPEC protocols.
Purpose of the Study:
- To report a rare case of localized cytotoxic skin injury following HIPEC.
- To discuss the diagnostic challenges and management of this adverse event.
- To raise awareness of potential skin complications associated with HIPEC.
Main Methods:
- A case study of a patient with left-sided colon cancer and peritoneal metastasis.
- The patient received neoadjuvant chemotherapy, followed by cytoreductive surgery and HIPEC.
- Diagnosis of skin injury was confirmed via skin biopsy.
Main Results:
- The patient developed a painful, erythematous, and ulcerative rash post-HIPEC.
- Skin biopsy revealed necrosis attributed to mitomycin C cytotoxic injury.
- Initial empiric treatments were ineffective, necessitating supportive care.
Conclusions:
- Localized cytotoxic skin injury is a rare but significant complication of HIPEC.
- Prompt diagnosis and supportive management are crucial for patient recovery.
- This case underscores the importance of recognizing and managing chemotherapy-induced skin toxicity.
