CTICasesMediastinitis and tracheoesophageal fistula from malpositioned chemotherapy port catheter
Imaging findings
CT scan shows malposition of a chemotherapy port catheter tip, which is located in the azygos vein rather than the superior vena cava. Repeated chemotherapy infusion through the azygos catheter resulted in severe mediastinal inflammation, cellulitis, and the development of a tracheoesophageal fistula requiring esophageal stenting.
Key takeaways
Catheter tip positioning must be verified after placement. Infusion of vesicant chemotherapeutic agents into small mediastinal veins like the azygos vein can cause chemical mediastinitis, necrosis, and fistulization to adjacent structures.
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