case_images: PMC5404631_01
case_images: A preoperative photograph. The patient was a 50-year-old woman with left breast cancer and a lumbar peritoneal shunt tube in her abdomen. Arrow: the scar of L-P shunt insertion. Dotted line: the subcutaneous course of shunt tube.
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case_images: PMC5404631_01_icrp_a_1296362_f0001_c.jpg
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case_images: Her breasts were large and drooping (Figure 1), and left nipple areola sparing mastectomy was scheduled.
case_images: A preoperative CT scan: the shunt tube pierced the intervertebral lumbar and traveled through the subcutaneous layer of the left trunk.
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case_images: F0002
case_images: A preoperative computed tomography scan showed the shunt tube, which pierced the intervertebral lumbar and traveled through the subcutaneous layer of the left trunk (Figure 2) and entered into the abdominal cavity from the outer edge of the left rectus abdominal muscle (Figure 3).
case_images: The shunt tube entered into the abdominal cavity from the outer edge of the left rectus abdominal muscle.
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case_images: F0003
case_images: A preoperative computed tomography scan showed the shunt tube, which pierced the intervertebral lumbar and traveled through the subcutaneous layer of the left trunk (Figure 2) and entered into the abdominal cavity from the outer edge of the left rectus abdominal muscle (Figure 3).
case_images: The shunt tube was detected but not exposed upon the elevation of the flap.
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case_images: The shunt tube, which was located on the fascia, was covered with fibrous tissue and was not directly exposed (Figure 4).
case_images: The tube was withdrawn from the abdominal cavity once and re-inserted 5 cm caudal from the original position on closure of the abdominal skin.
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case_images: We, therefore, dissected the tube from the surrounding tissue and temporally withdrew it from the abdominal cavity and re-inserted it 5-cm caudal from its original position by a brain surgeon (Figure 5).
case_images: There was no recurrence and good shape and symmetry were achieved at 1 year after surgery.
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case_images: Therefore, she received postoperative chemotherapy and radiotherapy, and there was no recurrence of the breast cancer and her reconstructed left breast showed good shape and symmetry in comparison with the right breast at one 1 year after surgery (Figure 6).