Subcutaneous seeding after ultrasound-guided placement of intrapleural catheter. An unusual complication of the intracavitary palliative treatment ofpleural mesothelioma

Intrapleural catheters are useful in the palliative treatment of malignant effusions. Complications are infrequent and of little importance. We report a case of subcutaneous implantation metastasis along the course of intrapl eural catheter, which had been placed under sonographic guidance in a patie nt with pleural mesothelioma. After drainage of the effusion, cisplatin plu s cytarabine was administered via the chest tube, achieving complete remiss ion of the pleural effusion. Subcutaneous metastasis became evident 3 month s later and was the only sign of disease progression for 2 months. The seed ing of cancer cells was probably caused by a small leakage of fluid around the chest tube that occurred during the placement procedure as a result of the increased intrapleural pressure caused by the large quantity of fluid t hat had accumulated in the pleural space.