Miglets A W, Letson J A, Speigel J C
Ann Otol Rhinol Laryngol. 1978 Sep-Oct;87(5 Pt 1):701-6. doi: 10.1177/000348947808700516.
Thorotrast, a radioactive contrast material used between 1930 and 1950, is often permanently retained within the patient. Individuals who have had diagnostic studies with Thorotrast may develop serious complications many years later. These complications fall into two major categories, desmoplastic and neoplastic. The inadvertent infiltration of Thorotrast into soft tissue, usually the neck during carotid arteriography, may later result in severe fibrosis with constriction of the surrounding vessels and nerves. Malignancies, the second major problem, have occurred at the site of previous Thorotrast instillations throughout the body. The following report describes the clinical course of an 82-year-old woman who presented with a Thorotrast induced desmoplastic reaction of her neck, complicated by pharyngeal necrosis and the development of a pharyngeal cutaneous fistula. The latter problem is quite rare, having been previously reported only once. Despite extensive tissue destruction conservative management prevailed. Repetitive debridement, controlling the intermittent infections, maintaining her nutritional status, and relieving her pain allowed spontaneous healing to occur.
钍造影剂是一种在1930年至1950年间使用的放射性造影剂，常永久留存于患者体内。接受过钍造影剂诊断检查的个体可能在多年后出现严重并发症。这些并发症主要分为两类，即纤维组织增生性和肿瘤性。钍造影剂意外渗入软组织，通常是在颈动脉造影期间渗入颈部，随后可能导致严重纤维化，并伴有周围血管和神经受压。恶性肿瘤是第二个主要问题，在全身先前注入钍造影剂的部位均有发生。以下报告描述了一名82岁女性的临床病程，她出现了钍造影剂诱发的颈部纤维组织增生反应，并伴有咽部坏死和咽皮肤瘘形成。后一个问题非常罕见，此前仅报道过一次。尽管组织遭到广泛破坏，但保守治疗仍占主导。反复清创、控制间歇性感染、维持她的营养状况并缓解疼痛，使其实现了自愈。
