Delayed Management of Chemoport Complication
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LETTER TO THE EDITOR
Delayed Management of Chemoport Complication Praveen S. Kammar 1 & Niharika Rajan Garach 1 & Shazia Waghoo 2 & Akshay Deshpande 3 & Sanket Mehta 4 Received: 15 April 2020 / Accepted: 15 September 2020 # Indian Association of Surgical Oncology 2020
We present a case of a 72-year-old lady with multiple comorbids treated outside for a T2N0 Triple-negative breast cancer. At the outset, she had chemoport extravasation which manifested as a swelling for which the port was removed. (Details of the chemoport and chemotherapy were not available). Over a period of 6 years, the swelling had increased in size and there were discharging sinuses with chronic pain. She presented to us with a 7 × 7 cm mobile swelling in the infraclavicular region extending to root of neck superiorly and medially upto mid clavicle (Fig. 1). CT scan displayed chest wall mass 6.2 × 2.2 × 8 cm sitting over pectoralis major with lot of calcification and no evidence of recurrence. She underwent resection of the swelling with a pedicled latissimus dorsi reconstruction (Figs. 2 and 3). She recovered well post operatively. Chemotherapy extravasation is a documented complication of chemoport [1]. There are various ways described in literature to manage it from surgical lavage to negative pressure wound therapy to debridement and flap reconstruction [1]. The point to make in our case was the large defect size and a delayed management of this complication. Hence though it is better to manage the patients immediately,
Fig. 1 Swelling in the pectoral region
* Praveen S. Kammar [email protected] Niharika Rajan Garach [email protected] Shazia Waghoo [email protected] Akshay Deshpande [email protected] Sanket Mehta [email protected] 1
Surgical Oncology, Saifee Hospital, Mumbai, Maharashtra, India
2
General Surgery, Kohinoor Hospital, Mumbai, Maharashtra, India
3
Plastic Surgery, Saifee Hospital, Mumbai, Maharashtra, India
4
Peritoneal Surface Oncology, Saifee Hospital, Mumbai, India
Fig. 2 Defect after resection
Indian J Surg Oncol
Compliance with Ethical Standards Conflict of Interest The authors declare that they have no conflict of interest.
Reference 1.
Haslik W, Hacker S, Felberbauer FX, Thallinger C, Barysch R, Kornauth C, Deutschmann C, Mader RM (2015) Port-a-cath extravasation of vesicant cytotoxics: surgical options for a rare complication of cancer chemotherapy. Eur J Surg Oncol 41(3):378–385
Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Fig. 3 Final outcome after reconstruction with Latissimus Dorsii Flap
but late reconstruction can also be offered with flap coverage for large defects.
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