title: Hoarseness: an unusual complication of port-A catheter perforation.
abstract: BACKGROUND
  A port-A catheter implantation for cancer patients is popular as a route for chemotherapy. Potential complications exist, such as perforation during chemotherapeutic agent infusion, especially when the port-A tip is incorrectly positioned or when it is in long-term use.
  
  
  METHODS
  We report on a patient who presented with hoarseness as a result of port-A catheter perforation-related mediastinitis subsequent to chemotherapeutic agent infusion through the catheter.
  
  
  CONCLUSIONS
  Hoarseness is a rare complication of port-A perforation and extravasation. To avoid perforation, the tip of the catheter should be located in a high-flow vessel, such as the distal superior vena cava rather than higher in the caval vein, to prevent a locally increased concentration of drugs. We also recommend that a venogram be arranged if extravasation is suspected.
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Jen-Chun
authors.initials: JC
authors.lastname: Wang
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Tsai
authors.forename: Cheng-Yi
authors.initials: CY
authors.lastname: Chan
authors.forename: Hsiang-Lin
authors.initials: HL
authors.lastname: Wan
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D004334:Drug Administration Schedule; D004868:Equipment Failure; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis*; D005260:Female; D006685:Hoarseness / Q000209:etiology*; D006801:Humans; D007262:Infusions, Intravenous; D008480:Mediastinitis / Q000139:chemically induced* / Q000175:diagnosis*; D010690:Phlebography; D012811:Sigmoid Neoplasms / Q000628:therapy*; D013350:Subclavian Vein / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D014826:Vocal Cord Paralysis / Q000139:chemically induced* / Q000175:diagnosis; D055815:Young Adult