A lethal complication after transarterial chemoembolization with drug-eluting beads for hepatocellular carcinoma.

Background. The current standard of care for patients with large or multinodular noninvasive hepatocellular carcinoma isconventional transarterial chemoembolization (TACE). TACE may also be performed with drug-eluting beads, but seriouscomplications of this procedure have been reported. Methods. Aim of this report is to present a patient affected by multifocal HCCwho underwent TACE with drug-eluting bead (DEB-TACE). Results. Following the procedure the patient developed a hepaticabscess and biliobronchial fistula resulting in adult respiratory distress syndrome and death. Conclusion. We speculate that DEBTACEhas a prolonged effect on the tumor and the surrounding liver, resulting in progressive enlargement of the necrotic area.Thisactivity that can extend to the surrounding healthy hepatic tissues may continue indefinitely.