Accidental venous port placement via the persistent left superior vena cava: Two case reports

BACKGROUND Breast cancer poses a great threat to females worldwide. There are various therapies available to cure this common disease, such as surgery, chemotherapy, radiotherapy, and immunotherapy. Implantable venous access ports (IVAP, referred to as PORT) have been widely used for breast cancer chemotherapy. Venous malformations are possible conditions encountered during PORT implantation. Persistent left superior vena cava (PLSVC) is a common superior vena cava malformation. Most patients have normal right superior vena cava without affecting hemodynamics, so patients often have no obvious symptoms. CASE SUMMARY We incidentally found that two patients had PLSVC while a PORT was implanted via the internal jugular vein. Due to chemotherapy for breast cancer, PORT was successfully implanted under the guidance of ultrasound into these 2 patients. Positive chest X-ray examination after the operation showed that the catheter ran beside the left mediastinum and the end was located in the seventh thoracic vertebra. The patients had no catheter-related complications and successfully completed the course of chemotherapy. Ultrasonography found that the ratio of PORT outer diameter to PLSVC inner diameter was less than 0.45, which was in line with the recommendations of relevant literature and operating guidelines. The purpose of this article is to introduce two rare cases and review the relevant literature. CONCLUSION Correct assessment of PLSVC status and ultrasound- guided PORT placement generally does not affect breast cancer patients chemotherapy.

Automated summary

This article presents two rare cases of incidental discovery of PLSVC during PORT implantation via the internal jugular vein. PORT was successfully implanted under ultrasound guidance in two breast cancer patients undergoing chemotherapy. Postoperative chest X-ray examination confirmed the correct placement of the catheter. The ultrasound examination showed that the ratio of PORT outer diameter to PLSVC inner diameter was in line with the recommendations of relevant literature and operating guidelines.