CASE REPORT article
Front. Oncol.
Sec. Pharmacology of Anti-Cancer Drugs
This article is part of the Research TopicExploring Cutaneous Drug-Related and Drug-Associated Adverse Events: From Clinical Insight to Therapeutic ManagementView all 8 articles
Case Report: Successful management of high-volume paclitaxel extravasation with hyaluronidase and dry warm compresses
Provisionally accepted
- 1Pharmacy of St. Elisabeth, St. Elisabeth Cancer Institute, Bratislava, Slovakia
- 2Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
- 31st Department of Oncology, Faculty of Medicine, Comenius University Bratislava and St. Elisabeth Cancer Institute, Bratislava, Slovakia
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Background: Paclitaxel is a widely used chemotherapeutic agent with known vesicant properties. Extravasation is rare, but it can result in significant local tissue injury. There is no consensus on the optimal management strategy, and recommendations differ significantly. Case presentation: We report the case of a 63-year-old woman with metastatic cervical cancer who experienced a large-volume paclitaxel extravasation during a peripheral infusion. Management involved immediate subcutaneous administration of hyaluronidase around the affected area, followed by repeated applications of dry warm compresses. The patient reported only mild discomfort during treatment, and the local cutaneous symptoms resolved within days. Despite effective local management, the patient developed persistent paresthesia in the extravasated limb, later diagnosed as sensory neuropathy affecting the ulnar nerve. This was accompanied by lower limb neuropathy, likely related to the systemic paclitaxel exposure. Paclitaxel was discontinued, and the patient continued palliative treatment with carboplatin monotherapy. Conclusion: Based on our literature search, this appears to be the first documented case of high-volume paclitaxel extravasation successfully managed with both hyaluronidase and dry warmth. The intervention proved to be effective in preventing severe local tissue injury, although it did not mitigate neurotoxic effects. Further research is needed to establish standardized management protocols.
Keywords: Paclitaxel, Extravasation, Vesicants, Hyaluronidase, Warm compresses
Received: 05 Sep 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Dudík, Kunderlík, Mriňáková, Lukáčová, Ušáková and Klimas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jan Klimas
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