Lymphatic Injury and Peripheral Lymphedema as Complications of Central Venous Catheter: A Case Report and a Literature Review

Abstract

Introduction: Secondary lymphedema is defined as a chronic-progressive disease which causes a rich protein edema of the limbs, this may be caused due to the damage or obstruction of lymphatic structures; secondary peripheral lymphedema may be considered a complication of central venous catheter procedures. Objective: To describe a clinical case of upper extremity lymphedema as venous port catheter related complication and present a review of literature of lymphatic complications of central venous catheter. Case Presentation: A 57-year-old woman received previous medical attention between 2019-2020 due to Hodgkin lymphoma; the patient was diagnosed by left cervical lymph node biopsy and received 12 chemotherapy cycles through right subclavian catheter. The patient arrived to our facilities in March 2021 to assess her case due to increased right arm volume related to progressive edema that did not improve with rest or elevation and began to limit movements and basic activities; the situation began after a previous right catheter infection and a change of it in January 2020 with no evidence of venous thrombosis and identified a worsening tendency with time since last chemotherapy in May 2020. After clinical history, physical examination and ICG NIR lymphography study, lymphedema was confirmed as a result of subclavian catheter related complication. We decided to present the case along a literature review on the topic. Conclusion: Lymphatic injury and peripheral lymphedema related to Central Venous Catheter procedures and its complications is a clinical reality that might be underrecognized and underdiagnosed by scientific literature and clinicians; this condition should be properly studied and deeply considered with the adequate assessment strategies in patients undergoing CVC procedures in the mid and long term to avoid its undertreatment.