Cervical dissecting extravasation of oxaliplatin: A case report

Abstract

Oxaliplatin is a chemotherapy drug considered to be an irritant and vesicant. Peripheral extravasation could happen following oxaliplatin chemotherapy administration, but mediastinal or cervical events are rare. The present study focused on the case of a 64-year-old female patient with KRAS-mutated colorectal adenocarcinoma. The patient was prescribed folinic acid, fluorouracil and oxaliplatin chemotherapy via a subcutaneous pump or port-a-cath device, which was inserted into the right subclavian vein. The patient reported a sudden throbbing pain in the chest wall and anterior cervical region. After performing a computed tomography scan, anterior cervical collection and jugular-subclavian venous confluence at the distal end was observed at the venous access site of the subcutaneous port-a-cath device, which extended cranially, dissected cervical planes and forming a hydro-aerial collection in the submaxillary region. Subsequently, the port-a-cath device was removed and a warm dry compress was applied. After 2 weeks, the patient had fully recovered without any sequelae at the cervical level. To the best of the authors' knowledge, this is the first case of cervical extravasation of oxaliplatin reported in the literature to date and will help to manage similar situations.

Keywords: extravasation; oxaliplatin.

Figure 1

Upper thoracic and cervical swelling (arrowed) during oxaliplatin infusion.

Figure 2

Computed tomography scan images of extravasation. (A) Air bubbles (arrowed) extended cranially, dissecting laterocervical planes. (B) Subcutaneous inflammation (arrowed) was observed in the upper thoracic wall.

Figure 3

Computed tomography scan images on day 10 following admission. Imaging findings indicated resolution of the cervical hydro-aerial collection (arrowed).