Ukai Machiko, Tomita Natsuo, Takaoka Taiki, Okazaki Dai, Torii Akira, Niwa Masanari, Kita Nozomi, Takano Seiya, Oguri Masanosuke, Matsuura Akane, Matsuura Fumihiko, Sato Tatsuya, Ohta Kengo, Hiwatashi Akio
Dept. of Radiology, Nagoya City University Graduate School of Medical Sciences.
Gan To Kagaku Ryoho. 2024 Jun;51(6):671-673.
A hydrogel spacer injection between the prostate and rectum is reported to reduce the risk of rectal toxicity in radiotherapy for prostate cancer. We present a case of an ectopic injection of hydrogel spacer. The patient was a 77-year-old male with intermediate-risk prostate cancer. It was planned that he would receive intensity modulated radiation therapy(IMRT), and a hydrogel spacer was inserted. Three days after insertion, the patient had a fever of 38.6℃ and presented frequent urination and perineal pain. Swelling and heat sensation were observed in the perineum. CRP was 12.00 mg/dL and the white blood cell count was as high as 9,300/μL. T2-weighted images showed a 5.3×1.9 cm high-intensity area around the lower urethra. Ectopic injection of hydrogel spacer and concomitant infection were diagnosed. Upon administering antibiotic treatment, his symptoms and inflammation improved immediately. Four months after hydrogel spacer insertion, T2-weighted images showed a high-intensity area in the lower urethra and around the ischial bone, which was attributed to the remaining hydrogel spacer. The hydrogel spacer and his symptoms completely disappeared at 9 months after hydrogel spacer insertion.
据报道，在前列腺和直肠之间注射水凝胶间隔物可降低前列腺癌放射治疗中直肠毒性的风险。我们报告一例水凝胶间隔物异位注射的病例。该患者为一名77岁的男性，患有中度风险的前列腺癌。计划对其进行调强放射治疗（IMRT）并插入水凝胶间隔物。插入后三天，患者发烧至38.6℃，出现尿频和会阴疼痛。会阴部观察到肿胀和热感。CRP为12.00mg/dL，白细胞计数高达9300/μL。T2加权图像显示尿道下段周围有一个5.3×1.9cm的高强度区域。诊断为水凝胶间隔物异位注射并伴有感染。给予抗生素治疗后，他的症状和炎症立即改善。插入水凝胶间隔物四个月后，T2加权图像显示尿道下段和坐骨周围有一个高强度区域，这归因于残留的水凝胶间隔物。水凝胶间隔物及其症状在插入水凝胶间隔物九个月后完全消失。
