Métastase d’une tumeur de la base de langue sur un système d’accès veineux central totalement implantable

Metastatic spread from squamous cell carcinoma of the hypopharynx to the totally implantable venous access port insertion site: Case report and review of literature

BACKGROUND

The totally implantable venous access port plays a crucial role in delivering chemotherapy in the outpatient setting. Here, we report the first case of a patient with hypopharyngeal tumor who developed chest wall metastasis over the totally implantable venous access port inserted in the internal jugular vein.

METHODS

Our patient, a 58-year-old man with a hypopharyngeal tumor presented with a lump over the totally implantable venous access port site. The port was removed and the lump was biopsied. The CT studies showed that the tumor had spread along the catheter from the hypopharynx to the chest wall.

RESULTS

The pathology from the biopsy showed squamous cell carcinoma (SCC). The patient had poor performance status and opted for hospice care.

CONCLUSION

We present a novel case of metastasis over the totally implantable venous access port implanted in a patient with a hypopharyngeal tumor. We also reviewed relevant literature comparing the data from percutaneous endoscopic gastrostomy (PEG) tube site metastasis with our patient and other similar case reports.

Metastasis over implantable venous access ports

BACKGROUND

The totally implantable venous access port (TIVAP) is an important device for patients receiving chemotherapy. We have reported, to our knowledge, the first case of a metastatic tumor over a TIVAP implanted via the Seldinger technique with a subclavian vein puncture.

METHODS

Our patient, a 48-year-old man with hard palate cancer, had metastasis over the TIVAP. CT studies showed that the tumor had spread along the catheter from the neck to the chest wall.

RESULTS

The cause of death was multiple lung metastases and intractable tumor bleeding over the TIVAP.

CONCLUSIONS

We present a novel case of metastasis over the TIVAP implanted by use of the Seldinger technique. This technique is used for patients receiving prolonged cytotoxic therapy for malignancy. Although the Seldinger technique is quick and more effective, we prefer the cephalic vein cut-down technique when an aggressive, advanced cancer of head and neck is involved.