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Iodized Oil Pleural Effusion in a Patient Previously Treated With Transarterial Chemoembolization for Hepatocellular Carcinoma

Simone Negrini, MD, PhD; Gabriele Zoppoli, MD; Enzo Andorno, MD; Antonino Picciotto, MD; Francesco Indiveri, MD; Practice Guidelines Committee, American Association for the Study of Liver Diseases
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From the Department of Internal Medicine (Drs Negrini, Zoppoli, Picciotto, and Indiveri), University of Genoa, Genoa, Italy; Division of General and Transplant Surgery (Dr Andorno), San Martino University Hospital of Genoa, Genoa, Italy; and the Laboratory of Molecular Pharmacology (Dr Zoppoli), Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Correspondence to: Simone Negrini, MD, PhD, Department of Internal Medicine, University of Genoa, V.le Benedetto XV, 6, 16132 Genova, Italy; e-mail: negrini@unige.it


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(1):193-195. doi:10.1378/chest.09-2213
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Transarterial chemoembolization (TACE) is a nonsurgical therapeutic option for the control of hepatocellular carcinoma (HCC) in patients with cirrhosis. Although less invasive than surgical approaches, this procedure can have severe side effects, with both local and extrahepatic complications, mostly related to treatment-induced ischemic damage. Here, we describe the case of a cirrhotic female patient affected by multinodular HCC, who presented with sudden onset dyspnea and chest pain. After a thorough follow-up, her condition was found to be due to iodinized oil pleural effusion following diaphragm rupture by a fistula. This had developed from a sterile abscess formed on the site of a previously performed TACE. We discuss the differential diagnosis and the management of this case, which, to our knowledge, has never been described as a late side effect of TACE.

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