Chemotherapy agent extravasation is a recognised complication of intravenous administration of antineoplastic therapy. This can result in persistent soft tissue injury, resulting in chronic pain and functional impairment. While acute management of chemotherapeutic agent extravasation is well described, there is limited literature addressing interventional options for patients who develop long-term chronic pain and functional impairment following extravasation. Case Summary: We describe a case of a 69-year-old patient with prostate cancer who attended our interventional pain clinic 6 months after extravasation of a 50 mL of intravenously administered Docetaxel into the soft tissues of the left forearm. The patient had tried conservative measures with no improvement. He presented with left forearm chronic pain, sensory deficit from mid biceps to left thumb, loss of fine motor skills, restriction of movement at elbow and wrist, and moderate left forearm lymphoedema. His ultrasound revealed diffuse deep fascial thickening and perineural fibrosis, most pronounced around the radial and ulnar nerves of the left forearm. Seven sessions of ultrasound-guided dextrose hydrodissection (DH) to areas of neural impingement and myofascial fibrosis was performed in the forearm. Each session was followed by manual fascial manipulation and manual lymphatic drainage. This resulted in near complete resolution of numbness, a return to the normal range of movement of the wrist and elbow, and a return of normal fine motor skills. His lymphoedema resolved, resulting in a drop in size of his compression garment after treatment. Conclusion: This case highlights the potential role of ultrasound-guided neural and fascial DH as a safe and effective interventional option for chronic fibrosis after Taxel chemotherapy extravasation.
- Open Access
- Case Report
Novel Use of Ultrasound-Guided 5% Dextrose Hydrodissection in a Case of Chronic Upper Limb Fibrosis after Docetaxel Extravasation
Author Information
Received: 08 Mar 2026 | Revised: 17 May 2026 | Accepted: 20 May 2026 | Published: 09 Jun 2026
Abstract
Keywords
docetaxel | chemotherapy extravasation | chronic fibrosis | prolotherapy | nerve hydrodissection | regenerative treatments | interventional pain
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