A 38-year-old woman receiving cancer treatment experienced a serious problem when a powerful cancer drug leaked out from her IV into the surrounding skin tissue. Instead of just waiting for it to heal on its own, doctors used a combination of treatments including special creams, antibiotics, and pain medicine. Within four weeks, her skin almost completely healed. This case shows that when cancer drugs leak under the skin, using multiple treatments together works better than doing nothing. The doctors also recommend that patients getting this particular cancer drug should use a special port (a small tube placed in a vein) rather than regular IVs to prevent this problem from happening in the first place.

The Quick Take

  • What they studied: What happens when a strong cancer drug leaks out from an IV into the skin, and what treatments work best to help the skin heal
  • Who participated: One 38-year-old woman with breast cancer who was receiving a drug called T-DM1 through a regular IV in her arm
  • Key finding: When the cancer drug leaked under her skin, doctors treated it with multiple medicines (creams, antibiotics, and pain relievers) and her skin healed almost completely in about 4 weeks
  • What it means for you: If you or someone you know is getting this cancer drug, using a special port (a small tube placed in a larger vein) is much safer than a regular IV. If a leak does happen, doctors should use several treatments together rather than waiting to see if it gets better on its own

The Research Details

This is a case report, which means doctors are describing what happened to one specific patient and how they treated her problem. The patient was a 38-year-old woman with a type of breast cancer who chose to receive her cancer drug through a regular IV in her arm instead of having a special port placed. When the powerful cancer drug (called T-DM1) leaked out of the IV into the surrounding skin tissue, she developed redness, blisters, and pain in that area.

The doctors decided to treat this problem aggressively using multiple different medicines at the same time. They used a strong steroid cream to reduce inflammation, a special cream that helps calm the immune system, antibiotics to prevent infection, high-dose vitamin D to support healing, and pain medicine to help her feel better. They tracked how her skin improved over time and documented the results.

This type of study is useful for teaching doctors about rare problems and new ways to treat them, but it only shows what worked for one person. It doesn’t prove that this treatment will work the same way for everyone.

This case is important because the cancer drug being used (T-DM1) is known to be irritating to skin if it leaks, but the instructions that come with the drug don’t clearly explain how to treat a leak if it happens. By describing how one patient was successfully treated, doctors can help other doctors know what to do if they see this problem in their own patients. It also shows that using multiple treatments together might work better than just watching and waiting.

This is a single case report, which is the lowest level of scientific evidence. It shows what worked for one person but doesn’t prove it will work for everyone. The patient had no other health problems before this happened, which made her case somewhat simpler than it might be for other patients. The doctors documented her treatment carefully and tracked her improvement, which makes the report more reliable. However, because it’s just one person, we can’t be sure these results would be the same for other patients.

What the Results Show

The patient developed significant skin damage when the cancer drug leaked under her skin, including widespread redness, blistering, and pain. When doctors treated this with a combination of four different types of medicine (a strong steroid cream, an immune-calming cream, antibiotics by mouth, and high-dose vitamin D), along with pain management, her skin improved dramatically. After about four weeks of treatment, her skin had almost completely healed.

This is notable because it suggests that treating the problem actively with multiple medicines works better than just watching and waiting. The combination approach addressed different parts of the problem: the steroid reduced inflammation, the immune-calming cream helped prevent further damage, the antibiotics prevented infection, and the vitamin D supported the skin’s natural healing process.

The patient tolerated all of the treatments well without serious side effects. The pain improved as the skin healed, suggesting that the pain was directly related to the skin damage from the drug leak. The fact that she had no other health problems before this happened may have helped her heal faster than patients with other medical conditions might.

Most doctors have been taught to treat drug leaks under the skin conservatively, meaning they watch and wait to see if the skin heals on its own. This case suggests that a more active approach using multiple treatments together might lead to faster healing and better results. However, because this is just one case, we can’t say for certain that this approach is better than the traditional approach without more research.

This is a report about just one patient, so we don’t know if the same treatment would work as well for other people. We don’t know if the patient’s age, overall health, or other factors helped her heal so well. The patient chose not to use a port, which is unusual—most patients getting this drug use a port to prevent this problem. We don’t have a comparison group of patients treated differently to see if this approach is truly better. Finally, we don’t know if the skin would have healed just as well with fewer medicines or a simpler treatment plan.

The Bottom Line

If you are receiving T-DM1 cancer treatment, strongly consider using a special port (a small tube placed in a larger vein) rather than a regular IV. This significantly reduces the risk of a drug leak. If a leak does occur, doctors should consider using multiple treatments together (including steroids, immune-calming creams, antibiotics, and vitamin D) rather than just watching and waiting. These recommendations are based on one successful case, so talk with your doctor about what’s best for your specific situation.

This information is most relevant for people with breast cancer who are being treated with T-DM1, their family members, and the doctors who care for them. It’s also useful for nurses and other healthcare workers who give IV medications. People receiving other types of IV drugs should also be aware that ports are safer than regular IVs for irritating medications.

In this case, the skin healed almost completely within 4 weeks of starting treatment. However, this timeline may be different for other patients depending on how much drug leaked, how quickly treatment was started, and the patient’s overall health. Some patients might heal faster or slower.

Want to Apply This Research?

  • If you’re receiving T-DM1 treatment, track the location of your IV or port, any signs of redness or swelling at the injection site, and any pain or discomfort. Take photos of the injection site weekly to monitor for any changes. Log this information in your health app along with dates of treatment.
  • Before each T-DM1 infusion, check your IV or port site carefully for any signs of problems. Ask your healthcare team about using a port instead of a regular IV. If you notice any redness, swelling, or pain during or after treatment, report it immediately to your doctor rather than waiting to see if it improves on its own.
  • Keep a weekly log of your IV or port site appearance and any symptoms. Set reminders to check the site daily for the first week after treatment and weekly for the following month. Share photos and notes with your healthcare team at each appointment. If any problems develop, increase monitoring to daily and contact your doctor immediately.

This case report describes what happened to one specific patient and should not be considered medical advice for your individual situation. If you are receiving T-DM1 or any IV cancer treatment, discuss the safest administration method with your oncologist. If you experience redness, swelling, blistering, or pain at an IV site during or after treatment, contact your healthcare provider immediately. Do not attempt to treat a drug leak on your own without medical guidance. This information is educational and is not a substitute for professional medical advice, diagnosis, or treatment.