Punctate Radiation Dermatitis of the Foot and Ankle Caused by Distal Embolization of 90Y Microspheres During Liver Directed Therapy

• Published in: Clinical nuclear medicine Vol. 42; no. 9; p. e422
• Main Authors: Nia, Benjamin B, Nia, Emily S, Avery, Ryan J, Kuo, Phillip H, Hennemeyer, Charles T
• Format: Journal Article
• Language: English
• Published: United States 01.09.2017
• Subjects: Adenocarcinoma - pathology; Adult; Ankle - radiation effects; Dermatitis - etiology; Embolization, Therapeutic - adverse effects; Foot - radiation effects; Humans; Liver Neoplasms - radiotherapy; Liver Neoplasms - secondary; Male; Microspheres; Radiation Injuries - etiology; Radiometry; Stomach Neoplasms - pathology; Yttrium Radioisotopes - adverse effects; Yttrium Radioisotopes - therapeutic use
• ISSN: 1536-0229
• DOI: 10.1097/RLU.0000000000001751

A 41-year-old man with gastric adenocarcinoma presented with hepatic metastases. The metastases were refractory to systemic chemotherapy, so radioembolization with Y microspheres was performed. Because of stasis or saturation of the tumor with embolic particles, 79% of the microspheres were injected. At follow-up, the patient complained of "red bumps" that had developed on his right foot/ankle the day after the radioembolization. Because a portion of the dose was still in the catheter when withdrawn from the right femoral artery, the interventional radiologist used a Geiger counter to confirm radioactivity in the cutaneous lesions and thus the distal embolization of the microspheres.