-Case Reports-

Injection-Site Granulomas Resulting from the Administration of Both Leuprorelin Acetate and Goserelin Acetate for the Treatment of Prostatic Cancer

Masaki Shiota, Noriaki Tokuda, Takehiro Kanou and Humio Yamasaki

Department of Urology and Pathology, Saga Prefectural Hospital, Koseikan

Although injection-site granulomas caused by leuprorelin acetate have been reported, there have been no reports of granulomas caused by both leuprorelin acetate and goserelin acetate. An 81-year-old man presented with subcutaneous nodules of the abdominal wall and upper arm, where 11.25 mg of leuprorelin acetate had been injected for the treatment of prostate cancer. Because of these nodules, treatment was changed to goserelin acetate. Nevertheless, he presented with another subcutaneous nodule at the injection site. Histological examination showed that these nodules consisted of numerous giant cells that were CD3-positive T lymphocytes and CD68-positive histiocytes associated with granulomatous changes. The granulomas had likely been caused by delayed-type hypersensitivity to leuprorelin acetate injection. The granuloma that formed after goserelin acetate injection might thus have developed owing to the immunogenicity of the previous leuprorelin acetate injections. The patient underwent surgical castration. The present case suggests that both leuprorelin acetate and goserelin acetate can cause injection-site disorders.

J Nippon Med Sch 2007; 74: 306-308

Keywords
goserelin acetate, granuloma, luteinizing hormone-releasing hormone analogue, leuprorelin acetate, prostatic neoplasms

Correspondence to
Masaki Shiota, Department of Urology and Pathology, Saga Prefectural Hospital, Koseikan, 1-12-9 Mizugae, Saga 840-0054, Japan
shiota1976@yahoo.co.jp

Received, March 16, 2007
Accepted, April 18, 2007