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

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.