Central venous catheter rupture following undiluted etoposide administration in a patient with multiple myeloma: A case report

Central venous catheter (CVC) rupture is an uncommon but clinically significant complication. We report a case involving a 59-year-old woman with multiple myeloma who experienced CVC rupture following prolonged infusion of undiluted etoposide (VP‑16). The patient received continuous VP‑16 infusion through a polyurethane double-lumen catheter and subsequently developed puncture-site pain, local oozing, and catheter malfunction. Radiography did not initially demonstrate catheter displacement or breakage. After multidisciplinary evaluation, the catheter was removed, revealing a longitudinal intraluminal crack with inward-concave deformity and brittle fragmentation. A small adherent intraluminal clot causing catheter occlusion was identified, and subsequent ultrasound confirmed catheter-related venous thrombosis of the internal jugular vein. The patient recovered following anticoagulation therapy. This case highlights solvent-induced degradation of polyurethane catheters by undiluted VP‑16 and underscores the importance of selecting appropriate catheter materials and monitoring for early signs of catheter damage.