We report an exceptional misplacement of a central venous catheter, fr
om the right jugular vein where it was introduced, into the right thyr
o-lingual-facial trunk. A brief description of the clinical course and
a literature review on catheter misplacement is presented. This case
illustrates the importance of routine use of a chest X-ray, and when n
ecessary contrast medium, to verify the correct location of the cathet
er tip.