title: Metastasis over implantable venous access ports.
abstract: BACKGROUND
  The totally implantable venous access port (TIVAP) is an important device for patients receiving chemotherapy. We have reported, to our knowledge, the first case of a metastatic tumor over a TIVAP implanted via the Seldinger technique with a subclavian vein puncture.
  
  
  METHODS
  Our patient, a 48-year-old man with hard palate cancer, had metastasis over the TIVAP. CT studies showed that the tumor had spread along the catheter from the neck to the chest wall.
  
  
  RESULTS
  The cause of death was multiple lung metastases and intractable tumor bleeding over the TIVAP.
  
  
  CONCLUSIONS
  We present a novel case of metastasis over the TIVAP implanted by use of the Seldinger technique. This technique is used for patients receiving prolonged cytotoxic therapy for malignancy. Although the Seldinger technique is quick and more effective, we prefer the cephalic vein cut-down technique when an aggressive, advanced cancer of head and neck is involved.
authors.affiliation: Department of Otolaryngology, E-Da hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chun-Hong
authors.initials: CH
authors.lastname: Lee
authors.forename: An-Shiou
authors.initials: AS
authors.lastname: Day
authors.forename: Tzer-Zen
authors.initials: TZ
authors.lastname: Hwang
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D021362:Palate, Hard / Q000473:pathology; D035583:Rare Diseases; D018570:Risk Assessment; D013899:Thoracic Neoplasms / Q000556:secondary* / Q000628:therapy; D035441:Thoracic Wall / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D062666:Vascular Access Devices / Q000009:adverse effects*