Abstract

BackgroundPosterior reversible encephalopathy syndrome (PRES) is a very rare complication secondary to transcatheter arterial chemoembolization (TACE). Only two patients with liver metastasis have been reported. We report for the first time two cases of hepatocellular carcinoma (HCC) patients occurred PRES secondary toTACE.Case presentationThe two patients with HCC developed headache, epilepsy, expressive aphasia, visual impairment and loss of consciousness, 11 and 3 h after conventional TACE (c-TACE) surgery. One patient experienced raised blood pressure during and after TACE, accompanied by a significant elevated creatinine. The magnetic resonance imaging (MRI) of the two patients showed multiple abnormal signals in the brain, mainly located in the white matter region. Combined with the clinical symptoms and MRI findings, PRES was diagnosed. Their symptoms and MRI changes improved significantly in the next two weeks.ConclusionThe PRES in this report is chemoembolization-associated syndrome, which might be related to the use of chemotherapy agents during TACE. And if neurological symptoms occur after TACE, patients should be closely monitored to exclude PRES.

Highlights

  • Posterior reversible encephalopathy syndrome (PRES) is a very rare complication secondary to transcatheter arterial chemoembolization (TACE)

  • The PRES in this report is chemoembolization-associated syndrome, which might be related to the use of chemotherapy agents during TACE

  • Lumpy tumor staining in the right lobe of the liver, and no artery-venous fistula was observed in the first intraoperative angiography of TACE. 1000 mg of 5-fluorouracil and 300 mg of calcium folinate were perfused through the proper hepatic artery for chemotherapy

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Summary

Conclusion

The PRES in this report is chemoembolization-associated syndrome, which might be related to the use of chemotherapy agents during TACE.

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