• Francisco Lopes Morgado, Bárbara Saraiva, Celestina Blanco Torres, and João Correia.
• Internal Medicine Department, Unidade Local de Saúde da Guarda, Guarda, Portugal.
• Eur J Case Rep Intern Med. 2021 Jan 1; 8 (1): 002161.

IntroductionPersistence of the left superior vena cava (LSVC) is a rare anatomical variant in the general population, with an estimated incidence of 0.3-0.5% in healthy individuals. It may be diagnosed incidentally after imaging control of the placement of a central venous catheter (CVC) or other device.Patient And MethodsWe present the case of a patient with acute disease who required central venous catheterization for the administration of intravenous chemotherapy.ResultsCentral venous catheterization proved difficult and imaging control revealed the catheter tip in an unusual position. Computed tomography to verify the catheter tip position revealed the presence of a persistent left superior vena cava. The patient then underwent the planned treatment with no complications associated with the CVC.ConclusionAlthough uncommon, persistence of the LSVC can have a significant impact in clinical practice, particularly when invasive procedures are required. Its recognition is important in order to minimize the potential complications inherent to such procedures.Learning PointsPersistence of the left superior vena cava is an uncommon anatomical variant of the central venous vascular anatomy.It is generally asymptomatic, and its diagnosis is often incidentally made after certain procedures (central venous catheterization).Diagnosis through chest x-ray alone is difficult and should be complemented with transthoracic echocardiography and computed tomography in order to minimize the complications inherent to central venous catheterization.© EFIM 2021.

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