Calderon Chrystal, Singh Nishana, Ramoutar Vanessa, Ramcharan Robert, Ramnarine Devindra
Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago.
Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago.
Int J Surg Case Rep. 2025 Jan;126:110701. doi: 10.1016/j.ijscr.2024.110701. Epub 2024 Nov 29.
Guidewire localization in breast conserving procedures is commonly performed. Although it is a relatively safe procedure, there are atypical complications that may occur. Here, we highlight a rare case of guidewire migration, affecting both the brain and spine.
This is the case of a 59-year-old female who underwent guidewire localization for a non-palpable breast mass nine (9) months prior to presentation to the neurosurgery outpatient clinic. At the time of the breast conserving procedure, the initial guidewire inserted could not be located, and a second one was placed. She presented with a one-month history of progressively worsening quadriparesis and headaches. Investigative imaging demonstrated the presence of a guidewire running along the cervical spinal canal and terminating in the left cerebellar hemisphere. She was monitored closely, with varied surgical interventions being considered. Auspiciously, she demonstrated resolution of her symptoms during this time and has remained clinically stable.
Guidewire localization is generally described as a simple, low-risk procedure. However, the associated impact of cases of migration to distal sites may be detrimental, affecting patient outcomes. There are critical steps that must be taken to avoid mishaps.
This is an extremely rare case of guidewire migration involving the central nervous system. It is essential that when guidewires are not located following insertion, further investigations are carried out to ensure that it is no longer in situ. This will avoid delayed presentations, with considerable associated morbidity and mortality.
在保乳手术中进行导丝定位是常见操作。尽管这是一个相对安全的手术，但仍可能出现非典型并发症。在此，我们重点介绍一例罕见的导丝移位病例，该导丝同时影响了大脑和脊柱。
这是一名59岁女性的病例，她在前往神经外科门诊就诊前9个月，因不可触及的乳腺肿块接受了导丝定位。在保乳手术时，最初插入的导丝无法找到，于是又放置了一根。她出现了渐进性加重的四肢瘫和头痛症状1个月。影像学检查显示有一根导丝沿颈椎管走行并终止于左小脑半球。她接受了密切监测，并考虑了多种手术干预措施。幸运的是，在此期间她的症状有所缓解，且一直保持临床稳定。
导丝定位通常被描述为一种简单、低风险的手术。然而，导丝移位至远处部位的相关影响可能是有害的，会影响患者的治疗结果。必须采取关键步骤以避免失误。
这是一例极其罕见的涉及中枢神经系统的导丝移位病例。在插入导丝后若无法找到导丝，必须进行进一步检查以确保其不再原位，这将避免出现延迟就诊以及相当大的相关发病率和死亡率。
