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Prostate brachytherapy seed embolization to the right renal artery
Ba D Nguyen1, Steven E Schild, William W Wong
1Department of Radiology, Mayo Clinic, Scottsdale, AZ, USA. nguyen.ba@mayo.edu
Brachytherapy
|February 14, 2009
Summary
Iodine-125 (I-125) radioactive seeds used in permanent prostate brachytherapy can migrate to the renal artery, causing flank pain and hematuria. Radiologists must be vigilant for this rare complication, especially in patients with a history of prostate brachytherapy.
Area of Science:
- Urology
- Radiology
- Medical Physics
Background:
- Permanent prostate brachytherapy using iodine-125 (I-125) seeds is a common treatment for localized prostate cancer.
- Seed migration is a rare but potential complication of brachytherapy procedures.
Observation:
- Three cases of seed embolization to the right renal artery following transperineal interstitial permanent prostate brachytherapy are presented.
- Patients presented with symptoms including flank pain and hematuria, mimicking renal stones on imaging.
- Imaging findings included seeds embedded in or embolized to branches of the right renal artery.
Findings:
- Prostatic seed embolization to the renal artery can manifest as pain and hematuria.
- This migration pattern may be misdiagnosed as renal lithiasis on cross-sectional imaging.
- Pulmonary arteriovenous malformation or right-to-left cardiac shunts are potential causes for this atypical seed relocation.
Implications:
- Increased awareness of potential seed migration to the renal artery is crucial for accurate diagnosis.
- Careful review of patient history and meticulous radiologic interpretation are essential for identifying this rare complication.
- Vigilance in imaging interpretation aids in the correct diagnosis of seed embolization in brachytherapy recipients.
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