Recurrent Ischemic Strokes in a Young Breast Cancer Patient Due to Interatrial Septal Perforation by a Chemotherapy Port Catheter

TL;DR

A young breast cancer patient experienced repeated strokes caused by a chemotherapy port catheter piercing the heart wall, highlighting the need to check catheter placement when new neurological symptoms occur.

Contribution

This case report highlights a rare but severe mechanical complication of chemotherapy port catheters leading to recurrent ischemic strokes.

Findings

A chemotherapy port catheter perforated the interatrial septum, causing recurrent ischemic strokes.

Catheter migration into the left atrium was identified via echocardiography.

Early catheter removal prevented further strokes during three months of follow-up.

Abstract

Totally implantable venous access ports (PACs) are widely used in oncology and are generally considered safe. However, rare mechanical complications may lead to severe consequences. We report the case of a 27-year-old woman undergoing chemotherapy for breast cancer who developed recurrent ischemic strokes likely due to interatrial septal perforation by a PAC catheter. Transthoracic echocardiography revealed migration of the catheter into the left atrium, creating a direct pathway for systemic embolization. Early recognition and catheter removal prevented further events, and no recurrent ischemic events were observed during the three months of follow-up. This case highlights the importance of assessing catheter malposition when new neurological symptoms arise after PAC placement.

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