Retained hub of a Port-a-Cath

Case contributed by Dr Jayanth Keshavamurthy

Presentation

Pain inferior to the right clavicle.

Patient Data

Age: 45 years
Gender: Female
X-ray

There is a normal cardiomediastinal silhouette with lungs expanded equally bilaterally. The trachea is midline. No pneumothorax, pleural effusion, infiltrate, or mass is seen. The osseous structures are intact. The soft tissues are unremarkable. Right chest Port-a-Cath with the tip within the proximal SVC.

X-ray

Post port removal from the right anterior chest wall. The retained connecting-hub of the Port-a-Cath can be visualised at the right 7th rib.

The cardiomediastinal silhouette is normal. Calcified right hilar lymph nodes are noted, along with a calcified granuloma in the right lung. There is no focal consolidation, pleural effusion or pneumothorax. The lungs are well inflated. Pulmonary vascularity is normal. Imaged osseous structures are intact.

Ultrasound

There is a 1.5 cm long fragment of retained tubing within the soft tissues of the right anterior chest wall. This finding is consistent with the piece of connecting tubing used to secure the catheter to the Port-a-Cath reservoir. Note is made of surrounding scar tissue. However, there is no abscess formation.

Case Discussion

Upon removal of the Port-a-Cath, the connecting hub was left behind. Ultrasound confirmed the finding a few days later and it was excised out. The hub was initially not detected on the plain radiograph.

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Case information

rID: 56572
Case created: 9th Nov 2017
Last edited: 13th Nov 2017
Inclusion in quiz mode: Included
Institution: Augusta University

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