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Annals of Plastic Surgery 2003-Apr

Delayed seroma formation secondary to docetaxel.

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Mark R Sultan
Shirley M Madhere

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Docetaxel (Taxotere; Aventis, Bridgewater, NJ) binds to tubulin, leading to the stabilization of microtubules, resulting in interference with mitosis in the S phase. This antitumor drug has been instrumental in the treatment of metastatic and node-positive breast cancer. Although it can produce several undesirable side effects, many of these are tolerable and reversible. Of the more significant toxicities, neutropenia is dose-limiting but also resolves with drug cessation, and fluid retention is chronic and cumulative. The occurrence of edema in patients may be mitigated by premedication with antihistamines and corticosteroids. However, recurrence or appearance of localized fluid collections several years after surgery have not been previously reported in the literature. The authors describe a case of seroma formation 4 years postoperatively in a patient who was treated with docetaxel (Aventis) years after her breast reconstructive procedure. Although the development of a seroma in the immediate or acute postoperative period is a fairly common consequence after latissimus dorsi harvest, it is unusual for a fluid collection to recur several years after the procedure. Although, indeed, the authors have not established a definite causal relationship between seroma formation and docetaxel (Aventis), the authors believe it important to consider the possibility of such an occurrence in the management of this subset of patients.

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