Prostate brachytherapy seed migration to the left testicular vein

Prostate brachytherapy seeds may detach from their initial insertion sites and migrate to lungs, heart, coronary artery, liver, kidney, and vertebral venous plexus. The authors present the left testicular vein as additional site of seed embolization.

The authors report a 68-year-old man with seed migration to the left testicular vein shortly after brachytherapeutic procedure. All imaging procedures obtained after the transperineal seed implant insertion are retrospectively analyzed in correlation with the patient's clinical course.

The retrospective imaging review shows a left lower abdominal seed anterior to the left psoas muscle. CT re-evaluation localizes the seed in the left testicular vein. This embolized seed was not initially identified on any imaging modality. Although there is no solid cause-effect proof in this case, the fully potent embolized seed may be contributory to the patient's testicular symptomatology.

The uncommon seed relocation to the left testicular vein is probably because of periprostatic-pampiniform venous communication.