Rare pulmonary infarction after superior epigastric artery chemoembolization of unresectable hepatocellular carcinoma

Nontarget organ complications are a rare, yet serious side effect of transarterial chemoembolization (TACE) procedures. We describe a case of a patient with unresectable hepatocellular carcinoma who subsequently developed right-lower-lobar pulmonary infarction approximately three weeks after receiving TACE, owing to an abnormal vascular connection between the superior epigastric artery and the distal right pulmonary artery. Our case stresses the importance of pre-operative planning and imaging to familiarize oneself with variations in vascular anatomy and to recognize symptoms associated with even the rarest complication associated with TACE procedures, so as to initiate treatment and improve patient outcome.