Cardiac and hepatic seed implant embolization after prostate brachytherapy

Prostate brachytherapy seed implants occasionally embolize to lungs because of their small size. They may lodge in the right cardiac cavities before reaching the pulmonary arteries and lungs. A rare instance of seed migration to the coronary artery through an existing right-to-left cardiac shunt or patent foramen ovale has also been reported. I present a case of seed implant relocation to the heart and left hepatic lobe by way of presumed different venous pathways represented by the periprostatic and hemorrhoidal venous plexuses, respectively.