[Giant subcutaneous hematoma with hemorrhagic shock induced by goserelin acetate injection for prostate cancer : report of a case]

Hinyokika Kiyo. 2014 Sep;60(9):455-8.
[Article in Japanese]

Abstract

A 87-year-old man was diagnosed with prostate cancer (cT2aN0M0 Gleason score 4+4 with initial prostate specific antigen of 23.4 ng/ml). Prostate cancer was treated with combined androgen blockade (goserelin acetate plus flutamide). He was administered goserelin acetate depot injection without any complications as an outpatient. However, 5 hours after he left the hospital, he came back to the hospital, complaining of lower abdominal pain. Abdominal computed tomography revealed a giant subcutaneous hematoma in the lower abdomen. Hemoglobin was 6.9 g/dl and blood pressure was lower than 80 mmHg. He was admitted and given a blood transfusion. Because of pre-disseminated intravascular coagulation score 6, it was hard to antagonize warfarin by Vitamin K (he had taken warfarin because of atrial fibrillation). Arteriography was performed and injury to a branch of the lower epigastric artery was found. Transcatheter arterial embolization was performed at the same time. Injecting goserelin acetate may cause severe arterial injury.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Goserelin / administration & dosage
  • Goserelin / adverse effects*
  • Goserelin / therapeutic use
  • Hematoma / chemically induced*
  • Hematoma / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prostatic Neoplasms* / drug therapy
  • Radiography
  • Shock, Hemorrhagic / chemically induced*
  • Shock, Hemorrhagic / diagnostic imaging

Substances

  • Antineoplastic Agents, Hormonal
  • Goserelin