We present a rare case of port malposition into the anterior mediastinum resulting in chemotherapy extravasation into the pleural cavity. While management of extravasation into soft tissues has been established, the data on treatment of mediastinal and intrapleural extravasation is limited. This case underscores how utilizing state-of-the-art technology like real-time intracavitary electrocardiography(IC-ECG) or transthoracic/subxiphoid ultrasound with the “bubble test”, rather than reliance on postoperative chest radiography, can help eliminate catheter malposition and its potential catastrophic consequences.
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