Malposition of subcutaneous central venous port system in a toddler with acute lymphoblastic leukemia: A case report

INTRODUCTION: Central venous port systems are essential for reliable and long-term venous access in children, mainly for cancer therapy, parenteral nutrition, administration of medications, blood transfusion, etc. However, complications either periprocedural, early, or delayed can be expected and may affect the venous port function, with occasional revision and even port removal. CASE PRESENTATION: A central venous port device was implanted in a 2.5-year-old boy for chemotherapy administration in the treatment of acute lymphoblastic leukemia. After a month he presented again to our clinic due to a venous port device dysfunction, and inability to aspirate blood or infuse medications. A reoperation was done that revealed a port chamber in-place rotation. The chamber was repositioned in the pouch and suture-fixated. No port-related problems occurred in the follow-up period. CLINICAL DISCUSSION AND CONCLUSION: Central venous port chamber rotation is among the rarest complications, which usually makes the port unusable. It should be quickly recognized, to avoid further damage, such as extravasation of the chemotherapeutic agent or mechanical chamber impairment. A reoperation is almost always needed with subsequent placement of the port in the correct position. This paper also emphasizes the key concepts of complication in implantable venous ports in children.