Thoracic Duct Injury in a Patient Undergoing Axillary Lymphadenectomy: A Case Report.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL

Case Reports in Medicine Pub Date : 2025-08-04 eCollection Date: 2025-01-01 DOI:10.1155/carm/9720159

Michelle Albano Ferreira, Juliana Oliveira Costa, Juliana Lopes de Aguiar Araújo, Kleyton Santos de Medeiros, Larissa Dos Santos Lourenço Ferreira, Ubiratan Wagner de Sousa, Macerly Layse de Menezes Dantas, Diana Taissa Sampaio Marinho Navarro

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Abstract

A 56-year-old female patient, with no significant comorbidities, presented with abnormal breast exam findings. Imaging revealed a 5.4-cm irregular nodule in the left breast, diagnosed as invasive breast carcinoma (NST, Grade 2). Neoadjuvant chemotherapy was initiated, leading to a reduction in lesion size. Surgical intervention included quadrantectomy, sentinel lymph node biopsy, and axillary lymphadenectomy, which revealed residual carcinoma and positive lymph nodes. Postoperatively, chylous drainage through a Portovac drain was observed, prompting reoperation, during which the injured lymphatic duct was identified. Conservative management with medium-chain triglycerides resulted in a progressive reduction of drainage. The patient was discharged on the 13th postoperative day, subsequently underwent adjuvant radiotherapy, and is currently receiving regular outpatient follow-up.

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腋窝淋巴结切除术患者胸导管损伤1例报告。

56岁女性患者，无明显合并症，乳房检查结果异常。影像学示左乳一5.4 cm不规则结节，诊断为浸润性乳腺癌（NST， 2级）。新辅助化疗开始，导致病变大小减少。手术干预包括象限切除术、前哨淋巴结活检和腋窝淋巴结切除术，发现残留癌和阳性淋巴结。术后观察到乳糜通过Portovac引流管排出，提示再次手术，在此过程中发现损伤的淋巴管。中链甘油三酯保守治疗导致引流逐渐减少。患者术后第13天出院，接受辅助放疗，目前门诊定期随访。

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