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Chemotherapy delivering port catheter fracture and migration into the heart: a life-threatening accident during neck dissection


Journal of Otolaryngology-ENT Research
Mohamed Dhaha, Asma Zahmoul, Souheil Jbeli, Alia Methnani, Rim Brahem, Sawsen Dhambri, Skander Kedous

Abstract

Objectives: port catheter fracture and migration could be an iatrogenic life-threatening
complication. We aimed to sensitize head and neck surgeons to this complication.
Observation: a 61-years old man was referred to our surgery department for management
of T3N0M0 laryngeal cancer after failure of preservative treatment. The patient had
received 2 cycles of chemotherapy and was judged a bad responder. A total laryngectomy
with bilateral neck dissection was indicated. The port catheter was kept in place for
possible further chemotherapy treatment. During neck dissection the catheter fractured and
migrated. Post operative CT scan showed the distal part of the catheter bulging in the right
cardiac chambers. The patient was transferred to an interventional cardiology unit where
the foreign body was successfully retrieved using femoral venous access.
Conclusion: port catheters are a real potential danger because of the risk of fracture and
migration of the distal part. Removal of these devices should be performed in collaboration
with medical care oncologists before every neck intervention.

Keywords

port catheter, chemotherapy, neck dissection, fracture, migration

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