Totally implantable venous access port implantation in a breast cancer patient with situs inversus totalis: A case report

Situs inversus totalis, a rare congenital condition characterized by complete mirror-image transposition of the thoracic and abdominal organs, has not previously been reported in patients with breast cancer. A 60-year-old woman with a 5-year history of left breast nodules was admitted. Contrast-enhanced breast magnetic resonance imaging and abdominal ultrasound revealed mirror-image transposition of the thoracic and abdominal organs. The patient was diagnosed with left breast cancer concomitant with situs inversus totalis. Preimplantation computed tomography revealed that the left internal jugular vein followed a straighter course to the right atrium than the right internal jugular vein. Under ultrasound guidance, a totally implantable venous access port was successfully placed via the left internal jugular vein. Neoadjuvant taxotere adriblastina cyclophosphamide chemotherapy was subsequently administered through the totally implantable venous access port before the patient underwent modified radical mastectomy for left breast cancer. Given the mirror-image anatomy, the anatomically relocated left internal jugular vein should be preferentially selected for totally implantable venous access port placement because of its more favorable anatomical course compared with the right internal jugular vein. To the best of our knowledge, this is the first reported case of totally implantable venous access port implantation in a patient with breast cancer and concurrent situs inversus totalis.