Chemotherapy taste and bronchospasm: a consequence of a fistula between the superior vena cava and the right main bronchi.

A 56-year-old female patient with upper lobe neoplasia of the right lung and superior vena cava syndrome. The patient complained about the taste of the medications during the chemotherapy sessions. Interventional radiology diagnosed cava-bronchial fistula when it injected contrast into the inferior and superior vena cava.

A 56-year-old female patient, ex-smoker with upper lobe neoplasia of the right lung. Superior vena cava (SVC) thrombosis and non-working port-a-cath catheter. The patient complained about the taste of the medications and bronchospasm during the chemotherapy sessions. The symptoms of the SVC syndrome were edema of the upper limbs, chronic cough and collateral circulation. No hemoptysis. Angiotomography with invasion of the SVC showed no signs of fistulas. Tip of the port-a-cath catheter located before occlusion of the SVC closely related to the pulmonary mass.

Interventional radiology diagnosed cava-bronchial fistula when it injected contrast into the inferior and SVC by port-a-cath and angiographic catheters (Fig. 1A and B). With no possibility of treating SVC syndrome, a new catheter was implanted and removed.

Figure 1

(A) Injection of contrast through the vertebral catheter and contraction of the trachea by the cava-tracheal fistula. (B) Injection of contrast through the port-a-cath and contraction of the trachea by the cava-tracheal fistula.

Vena cava-bronchus fistula is rare, which can lead to catastrophic bleeding during the course of the disease [1]. There are no reports in the literature of a fistula between the SVC and trachea.