Doxorubicin Extravasation from a Port-a-cath into Pleural Space in a Young Girl: A Case Report and Review of Literature.

Abstract

Extravasation of chemotherapeutic agents from a peripheral cannula is a known problem, and to prevent that, oncology units use central vein access with indwelling catheters such as port-a-cath or Hickman catheter. The intrapleural extravasation of chemotherapeutic agents is a rare event. We describe a 9-year-old girl with newly diagnosed Ewing's sarcoma of the left upper humerus receiving neoadjuvant chemotherapy through a newly inserted port-a-cath device. The patient developed tachypnea and right-sided chest pain on day 2 of chemotherapy. The radiological investigations confirmed the extravasation of doxorubicin into the pleural space. The surgical washout with chest-drain insertion was done, and we continued flushing with normal saline until the drain fluid became clear. She has completed neoadjuvant therapy. This case report shines light into scenarios where extravasation of anthracycline into the pleural cavity or thorax can be managed conservatively and in settings where dexrazoxane is unavailable without causing much delay in restarting the chemotherapy.

• Authors: Alex Tom, Jayatheerth Joshi, Manoj Kumar Golla, Harsha Prasad Lashkari
• Journal: Journal of Indian Association of Pediatric Surgeons (J Indian Assoc Pediatr Surg) 2022 Sep-Oct Vol. 27 Issue 5 Pg. 648-651 ISSN: 0971-9261 [Print] India
• PMID: 36530827 (Publication Type: Case Reports)
• Copyright: Copyright: © 2022 Journal of Indian Association of Pediatric Surgeons.