Complex upper arm reconstruction using an antero-lateral thigh free flap after an extravasation of Yttrium-90-ibritumomab Tiuxetan: A case report and literature review.

Abstract

Yttrium-90-Ibritumomab Tiuxetan (Zevalin®) is used in the treatment of non- Hodgkin's lymphoma. Extravasation is an iatrogenic complication that is fortunately rare. However, the treatment of this complication is often complex due to the risk of extensive skin necrosis and unpredictable evolution of localized irradiation. This vesicant drug requires emergency management when extravasation occured. Radiations burns have specificities. Therefore, wound coverage involves specific plastic surgical techniques. Here, we report the case of a man presenting a chronic and extensive skin necrosis of upper arm treated with an antero-lateral thigh free flap. Moreover, we compare our experience of Zevalin® extravasation management to other past publications and propose recommendations to prevent this unacceptable complication.

• Authors: A Baus, C Keilani, C-S Bich, F Entine, M Brachet, P Duhamel, J-C Amabile, J V Malfuson, E Bey
• Journal: Annales de chirurgie plastique et esthetique (Ann Chir Plast Esthet) Vol. 63 Issue 2 Pg. 175-181 (Apr 2018) ISSN: 1768-319X [Electronic] France
• PMID: 29290464 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Chemical References

• Antibodies, Monoclonal
• ibritumomab tiuxetan

Topics

• Aged
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Arm (pathology, surgery)
• Extravasation of Diagnostic and Therapeutic Materials (complications)
• Free Tissue Flaps
• Humans
• Lymphoma, Mantle-Cell (drug therapy)
• Male
• Necrosis (chemically induced, surgery)
• Plastic Surgery Procedures (methods)
• Thigh (surgery)