Distal catheter of VP shunt detected by breast ultrasound

Case contributed by Giorgio M. Baratelli
Diagnosis certain

Presentation

Breast screening with ultrasound in an asymptomatic woman.

Patient Data

Age: 45 years
Gender: Female

Ultrasound of the upper quadrants of the right breast show the distal catheter of VP shunt: a small round hypoechoic structure, with regular and faint acoustic absorption, is detected under the skin in front of the pectoral major muscle.

Case Discussion

The catheter of a VP shunt is tunneled under the skin of the chest and runs behind the breast to reach the peritoneal cavity, where the CSF is drained.

In thin patients the catheter is palpable under the skin of the upper quadrants of the breast, but in larger patients the catheter is not palpable and the ultrasound diagnosis without medical history data can cause difficulties.

In female patients with VP shunt, mammography could break the tube and lead to the formation of a breast CSF pseudocyst.

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