Skin rash in the hypogastric region during a regional chemotherapy for bladder carcinoma: CT and scintigraphic demonstration of a potential collateral pathway between the internal iliac and inferior epigastric arteries

A 70-year-old man developed a skin rash in his right lower abdominal wall after an intra-arterial infusion chemotherapy for carcinoma of the bladder. A CT with a direct infusion of contrast material via the implanted reservoir showed a marked enhancement of the right inferior epigastric artery and a significantly large artery in the right inguinal region. Radionuclide imaging with a direct infusion of Tc-99m macroaggregated albumin (MAA) revealed an abnormal accumulation in the right anterior abdominal wall. These findings implied a collateral pathway from the right internal iliac artery to the right inferior epigastric artery, i.e., the corona mortis.