Mitomycin extravasation injury: A case series
Karolina Mieczkowska, Alana Deutsch, Bijal Amin, Adnan Mir, Renu Abraham, Yevgeniy Balagula, Rachel C. Blasiak, Ranon Mann, Parth Patel, Tagai Musaev, Tian Hao Zhu, Shalom Kalnicki, Stuart H. Packer, Beth N. McLellan
Abstract
Mitomycin C (MMC) is a DNA-alkylating chemotherapeutic agent mostly used in the treatment of adenocarcinomas of the gastrointestinal tract.1 Due to its toxicity, inadvertent extravasation of this medication can cause local skin and soft tissue injury. Acute symptoms are mild with erythema, swelling, and pain.2 Weeks later, indolent ulcerations can appear with severe local necrosis, resembling doxorubicin extravasation.3 Additionally, rare cases of delayed MMC extravasation reactions have been reported occurring months after infusion and are typically associated with an identifiable effector that alters vascular permeability such as radiation therapy, sunburn, or alcohol.