title: Subcutaneous seeding after ultrasound-guided placement of intrapleural catheter. An unusual complication of the intracavitary palliative treatment of pleural mesothelioma.
abstract: Intrapleural catheters are useful in the palliative treatment of malignant effusions. Complications are infrequent and of little importance. We report a case of subcutaneous implantation metastasis along the course of intrapleural catheter, which had been placed under sonographic guidance in a patient with pleural mesothelioma. After drainage of the effusion, cisplatin plus cytarabine was administered via the chest tube, achieving complete remission of the pleural effusion. Subcutaneous metastasis became evident 3 months later and was the only sign of disease progression for 2 months. The seeding of cancer cells was probably caused by a small leakage of fluid around the chest tube that occurred during the placement procedure as a result of the increased intrapleural pressure caused by the large quantity of fluid that had accumulated in the pleural space.
authors.affiliation: Dipartimento di Medicina Interna e Oncologia Medica, Azienda Ospedaliera, Ferrara, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sartori
authors.forename: I
authors.initials: I
authors.lastname: Nielsen
authors.forename: L
authors.initials: L
authors.lastname: Trevisani
authors.forename: D
authors.initials: D
authors.lastname: Tassinari
authors.forename: V
authors.initials: V
authors.lastname: Abbasciano
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000473:pathology / Q000628:therapy*; D009366:Neoplasm Seeding; D010166:Palliative Care; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D010997:Pleural Neoplasms / Q000473:pathology / Q000628:therapy*; D012878:Skin Neoplasms / Q000209:etiology* / Q000556:secondary; D014463:Ultrasonography