Troubleshooting an unusual complication following intrathecal chemotherapy delivered via Ommaya catheter: A case report

Mauler,David   J.; Richter,Kent   R.; Merrill,Sarah; Valencia‑Sánchez,Cristina; Krishna,Chandan; Mrugala,Maciej   M.

doi:10.3892/mco.2020.2032

July-2020 Volume 13 Issue 1

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July-2020 Volume 13 Issue 1

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Case Report

Troubleshooting an unusual complication following intrathecal chemotherapy delivered via Ommaya catheter: A case report

Authors:
- David J. Mauler
- Kent R. Richter
- Sarah Merrill
- Cristina Valencia‑Sánchez
- Chandan Krishna
- Maciej M. Mrugala
View Affiliations / Copyright

Affiliations: Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85259, USA, Department of Neurology, Mayo Clinic, Phoenix, AZ 85054, USA, Department of Neurosurgery, Mayo Clinic, Phoenix, AZ 85054, USA
Pages: 76-79
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Published online on: April 22, 2020

https://doi.org/10.3892/mco.2020.2032
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Abstract

The authors report the case of a 39‑year‑old woman with leukemic meningitis. A right frontal Ommaya reservoir was placed for intrathecal chemotherapy. During and immediately following the first injection of chemotherapy, the patient developed an episode of nausea, emesis, frontal headache and diarrhea. These same symptoms were later elicited during a second and third administration of chemotherapy. Post‑placement head computed tomography showed the tip of the catheter projecting approximately 1.5 cm inferior to the floor of the left frontal ventricle. After a revision of the Ommaya catheter due to suboptimal positioning, subsequent intrathecal chemotherapy administration was tolerated without any of the adverse symptoms previously encountered. The case documents an unusual complication arising from catheter migration in the setting of intrathecal chemotherapy and also demonstrates the value in troubleshooting Ommaya reservoir complications rather than prematurely abandoning its use in favor of lumbar puncture.

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1	Cohen-Pfeffer JL, Gururangan S, Lester T, Lim DA, Shaywitz AJ, Westphal M and Slavc I: Intracerebroventricular delivery as a safe, long-term route of drug administration. Pediatr Neurol. 67:23–35. 2017.PubMed/NCBI View Article : Google Scholar
2	Mead PA, Safdieh JE, Nizza P, Tuma S and Sepkowitz KA: Ommaya reservoir infections: A 16-year retrospective analysis. J infect. 68:225–230. 2014.PubMed/NCBI View Article : Google Scholar
3	Lishner M, Perrin RG, Feld R, Messner HA, Tuffnell PG, Elhakim T, Matlow A and Curtis JE: Complications associated with Ommaya reservoirs in patients with cancer. The Princess Margaret Hospital experience and a review of the literature. Arch Intern Med. 150:173–176. 1990.PubMed/NCBI
4	Bin Nafisah S and Ahmad M: Ommaya reservoir infection rate: A 6-year retrospective cohort study of Ommaya reservoir in pediatrics. Childs Nerv Syst. 31:29–36. 2015.PubMed/NCBI View Article : Google Scholar
5	Montes de Oca Delgado M, Cacho Diaz B, Santos Zambrano J, Guerrero Juárez V, López Martínez MS, Castro Martínez E, Avendaño Méndez-Padilla J, Mejía Pérez S, Reyes Moreno I, Gutiérrez Aceves A and González Aguilar A: The comparative treatment of intraventricular chemotherapy by ommaya reservoir vs. Lumbar puncture in patients with leptomeningeal carcinomatosis. Front Oncol. 8(509)2018.PubMed/NCBI View Article : Google Scholar
6	Lau JC, Kosteniuk SE, Walker T, Iansavichene A, Macdonald DR and Megyesi JF: Operative complications with and without image-guidance: A systematic review and meta-analysis of the Ommaya reservoir literature. World Neurosurg. 122:404–414. 2019.PubMed/NCBI View Article : Google Scholar
7	Sundaresan N and Suite ND: Optimal use of the Ommaya reservoir in clinical oncology. Oncology (Williston Park). 3:15–22; discussion 23. 1989.PubMed/NCBI
8	Papanastasiou L, Fountoulakis S, Pappa T, Liberopoulos K, Malliopoulos D, Markou A and Piaditis G: Brain and optic chiasmal herniation following cabergoline treatment for a giant prolactinoma: Wait or intervene? Hormones (Athens). 13:290–295. 2014.PubMed/NCBI View Article : Google Scholar
9	Livshits Z, Rao RB and Smith SW: An approach to chemotherapy-associated toxicity. Emerg Med Clin North Am. 32:167–203. 2014.PubMed/NCBI View Article : Google Scholar
10	Kerr JZ, Berg S and Blaney SM: Intrathecal chemotherapy. Crit Rev Oncol Hematol. 37:227–236. 2001.PubMed/NCBI View Article : Google Scholar
11	Kwong YL, Yeung DY and Chan JC: Intrathecal chemotherapy for hematologic malignancies: Drugs and toxicities. Ann Hematol. 88:193–201. 2009.PubMed/NCBI View Article : Google Scholar
12	Babic T and Browning KN: The role of vagal neurocircuits in the regulation of nausea and vomiting. Eur J Pharmacol. 722:38–47. 2014.PubMed/NCBI View Article : Google Scholar
13	Whitehead WE, Riva-Cambrin J, Wellons JC III, Kulkarni AV, Browd S, Limbrick D, Rozzelle C, Tamber MS, Simon TD, Shannon CN, et al: Factors associated with ventricular catheter movement and inaccurate catheter location: Post hoc analysis of the hydrocephalus clinical research network ultrasound-guided shunt placement study. J Neurosurg Pediatr. 14:173–178. 2014.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Troubleshooting an unusual complication following intrathecal chemotherapy delivered via Ommaya catheter: A case report

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