酢酸リュープロレリン皮下注射により生じた炎症性肉芽腫に対して外科的切除を行った1例

Abstract

76歳男.前立腺癌の治療で酢酸リュープロレリン3ヵ月製剤注射後に, 下腹部の3ヶ所の皮下注射部位に一致して硬結, 発赤, 自発痛が出現し, 一部壊死, 皮膚表面の潰瘍, 感染を認めた.CTスキャン所見にて腹部皮下に腫瘤結節を認め, 肉芽腫の診断で腹部皮下腫瘤摘除術, 根治的前立腺全摘除術を行った.皮下硬結は病理学的に炎症性肉芽腫であった.術後約6ヵ月現在, 再発, 転移は認めない.なお, 今までに, 酢酸リュープロレリン皮下注射部位に生じた炎症性肉芽腫の報告は数例あるが, 本症例のような症状が生じて腫瘤摘除を行った症例はこれが最初である

A case of granuloma which developed following a subcutaneous injection of leuprorelin acetate is presented. A prominent induration developed at the site of injection with a three-month type preparation, and radical retropubic prostatectomy and simultaneous excision of the granulomas were requested by the patient since they were large, infectious and painful. Our experience may indicate the necessity of conversion from leuprorelin acetate to other drugs (e.g., goserelin acetate, castration) if a local induration, caused by a subcutaneous injection of leuprorelin acetate, has developed to a large granuloma.