Histopathogenesis of Skin and Subcutaneous Injury Induced by Adriamycin

Luedke, Dan W.; Kennedy, Peter S.; Rietschel, Robert L.

doi:10.1097/00006534-197904000-00003

Cited by 68 publications

(17 citation statements)

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“…Instead, intra-dermal injections of doxorubicin in various animal species were used for this purpose (Luedke et al, 1979;Rudolph et al, 1979;Dorr et al, 1980;Averbuch et al, 1988;Balsari et al, 1989). In our studies, however, we have been able to consistently produce skin wounds in female B6D2F1 mice using subcutaneous injections of 50 l of a 1.2 mg/mL doxorubicin or daunorubicin solution.…”

Section: Discussionmentioning

confidence: 90%

A murine experimental anthracycline extravasation model: Pathology and study of the involvement of topoisomerase II alpha and iron in the mechanism of tissue damage

Thougaard¹,

Langer

Hainau

et al. 2010

Toxicology

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Section: Discussionmentioning

confidence: 90%

A murine experimental anthracycline extravasation model: Pathology and study of the involvement of topoisomerase II alpha and iron in the mechanism of tissue damage

Thougaard¹,

Langer

Hainau

et al. 2010

Toxicology

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“…Further histological studies of these doxorubicin-induced ulcers showed a necrotic lesion with a lack of in ammatory response, and a primary vascular or vasospastic mechanism was suggested. 15 This lack of in ammatory in ltrate could be the main factor interfering with revascularisation and healing. 12 Histological studies of human ulcers 2-3 months after extravasation showed patent blood vessels at the edge of the ulceration and dense scarring in the dermis.…”

Section: Discussionmentioning

confidence: 99%

A Sarcoma at the Site of Previous Extravasation of Adriamycin

Ceulemans

Wever

Sciot

et al. 2002

Sarcoma

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Case reportA 66-year-old man was treated for a malignant brous histiocytoma of the proximal left tibia, without metastases, 16 years previously.After one course of neoadjuvant chemotherapy with bleomycin-dactinomycin-cyclophosphamide and two cycles of high-dose methotrexate, an above-knee amputation of the left lower limb was performed.Postoperatively the patient received adjuvant chemotherapy with CDDP-adriamycin (doxorubicin)-bleomycin-cyclophosphamide and dactinomycin.During one of the chemotherapy administrations, extravasation of adriamycin occurred in the tissues around the basilic vein at the left elbow. No skin necrosis occurred. After a period of local erythema and swelling, a multinodular sclerotic lesion developed, consisting of four to ve noduli of 0.5-1 cm diameter, xed to the skin and underlying biceps muscle which also became indurated.The lesions were situated along the basilic vein from the elbow up to where the adriamycin extravasation had occurred (Fig. 1).Over a period of 16 years there was no evidence of tumour recurrence. The patient remained in good health and the nodules at his left elbow did not change in size or number. The patient consulted this year because of a fast growing mass above the left elbow at the extravasation site. One of the nodules had signicantly increased in size over a period of 1 month.On examination, the mass was 6 cm in diameter, xed to the underlying biceps muscle and overlying skin, multinodular and non-tender.Magnetic resonance imaging showed a tumour of 2 ´2.5 ´4 cm on the ulnar side of the biceps muscle with thickening of the overlying skin (Fig. 2). Computerized tomography of chest and abdomen did not show metastases except for a small nodular lesion at the pleura of the left upper lobe.A resection of the mass en bloc with the medial head of the biceps, part of the brachialis muscle, and the subcutaneous tissue and overlying skin was performed. A split thickness skin graft was used to cover the defect.Postoperative wound healing was somewhat delayed because of partial loss of the skin graft due to a hematoma.Two months after the procedure a new CT scan of the chest showed a clear increase in volume of the previously described nodule. Even more pleural nodules were seen, which were highly suggestive for pleural metastasis. The patient was subsequently treated with four cycles of ifosfamide with partial response: only the initially described nodule was still present. Via a left thoracotomy, a resection of the nodule en bloc with the lateral side of ribs 4 and 5 was done. A second nodule was palpated intraoperatively and resected with the lateral side of rib 3. Multiple scars in the left lung, especially in the lingula, were seen and one of these lesions was excised. A recon- AbstractWe report the case of a 66-year-old man presenting with a high-grade pleomorphic sarcoma at the left elbow 16 years after the extravasation of adriamycin given for a malignant brous histiocytoma of the tibia. We suggest that this sarcoma originated in a multistep way over many year...

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“…Such lesions are often extremely slow to heal, and skin grafting is frequently mandatory. With doxorubicin, the use of glucocorticoids has been discouraged [10] because the number of inflammatory cells [7] in the perinecrotic tissue is low, thus rendering the mechanism of action of glucocorticoids irrelevant. However, doxorubicin attracted many inflammatory cells in treated eyelids [8], producing a marked increase in vascular permeability.…”

Section: Discussionmentioning

confidence: 99%

Docetaxel extravasation

Berghammer

Pöhnl

Baur

et al. 2001

Support Care Cancer

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We report on an accidental extravasation of docetaxel given intravenously as chemotherapy in a cancer patient. The extravasate was immediately diluted subcutaneously with saline, in addition to which hypothermia (ice-packs) was implemented and topical dimethylsulfoxide (DMSO) was applied three times every 45 min. Corticosteroids and diclofenac were also administered. Dermatitis developed immediately but had disappeared within 24 h. Notably, dermatopathological changes were absent on days 2-4, minimal on day 5, and increased thereafter. Dermatitis developed as a late symptom, resulting in brown discoloration and skin hyperplasia. No plastic surgical intervention was necessary. We propose that isotonic saline, topical DMSO and local hypothermia may have restricted the inflammation and tissue necrosis induced by the extravasation of docetaxel. Repetitive topical application of DMSO beyond the day of extravasation had no additional benefit.

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Histopathogenesis of Skin and Subcutaneous Injury Induced by Adriamycin

Cited by 68 publications

References 0 publications

A murine experimental anthracycline extravasation model: Pathology and study of the involvement of topoisomerase II alpha and iron in the mechanism of tissue damage

A murine experimental anthracycline extravasation model: Pathology and study of the involvement of topoisomerase II alpha and iron in the mechanism of tissue damage

A Sarcoma at the Site of Previous Extravasation of Adriamycin

Docetaxel extravasation

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