Radiology Commons^™

Accidental Extravasation Of Mitomycin C Into The Subcutaneous Tissue, Johnathon Chung, Brooke Walterscheid, Jose Lopez-Vera, Hytham Rashid, Mike K. Liang

HCA Healthcare Journal of Medicine

Introduction

Mitomycin C (MMC) is a common chemotherapeutic agent used to treat a variety of solid tumors. Cutaneous adverse events are rare, but MMC is a known vesicant reported to cause tissue necrosis and sloughing, erythema, and ulceration if incorrectly infused into the subcutaneous tissue. Definitive treatment of extravasation injuries due to MMC depends on the severity of the cutaneous manifestation, which includes stopping the infusion, removing the catheter, or possible debridement.

Case Presentation

We present the case of a 70-year-old female with extensive soft-tissue injury secondary to extravasation of MMC that required hospital admission and surgical intervention to remove …

Medical Imaging Stewardship And Healthcare Savings: Utilization Of Age Adjusted D-Dimer To Rule Out Acute Pulmonary Embolism, Phillip Bloodworth, Casey Morris, Kenneth Cail, Brian L. Pando, Brian Helmly

HCA Healthcare Journal of Medicine

Introduction

Acute pulmonary embolism (PE) is a common diagnosis that can lead to death if left untreated. Computerized tomography pulmonary angiogram scan (CTPA) is the gold standard for diagnosis of PE. Utilization of CTPA is increasing in the emergency setting even when suspicion for PE is very low. While CTPA is helpful, radiation exposure, contrast reactions, and cost must be considered. D-dimer is a well-established, high sensitivity and low specificity laboratory test that can effectively rule out PE in low-risk patients when negative. The ADJUST-PE trial showed that there is a natural rise of D-dimer levels with age. This age …