Subdermal contraceptive implant migration to pulmonary artery branch

Abstract

Subdermal contraceptive implants are now commonly used throughout the world. One of the rare complications of these implants is migration to the lungs due to misplacement of the implant during insertion, with only a limited number of cases documented. Here, we present a case where a subdermal contraceptive implant embolised in the subsegmental branch of the pulmonary artery within the anterobasal segment of the left lower lobe. Due to incorrect placement, the subdermal implant migrated from subcutaneous plane into one of the upper extremity veins. It then travelled the venous pathway to the heart, passed through the right atrium and ventricle, transferred into the left pulmonary artery and eventually embolised into the anterobasal segmental branch. Treatment options for such cases include endovascular retrieval, mini-thoracotomy (open thoracic surgery, video-assisted thoracoscopic wedge or segmental resection) or conservative management.