[Thorotrastosis: survey and CT pattern (author's transl)]

Area of Science:

• Radiology
• Oncology
• Medical History

Background:

• Thorotrast, a thorium dioxide-based contrast agent, was widely used for diagnostic imaging between 1930 and 1951.
• Long-term adverse effects, including delayed-onset cancers, have been associated with Thorotrast exposure.
• Understanding the long-term consequences and detection methods for Thorotrast-induced pathologies is crucial.

Observation:

• A 60-year-old male patient developed a hepatocholangiolar carcinoma 35 years after undergoing carotid angiography with Thorotrast.
• Computer tomography (CT) was utilized to determine the size and dimensions of the induced carcinoma.
• Pathologic tissue density was significantly increased (20x) in parapancreatic lymph nodes, moderately in the liver, and twofold in the spleen.

Findings:

• CT imaging successfully identified a Thorotrast-induced hepatocholangiolar carcinoma.
• Elevated tissue density in lymph nodes and organs indicates the presence and long-term retention of Thorotrast.
• The findings correlate Thorotrast exposure with the development of malignancy and significant tissue alterations.

Implications:

• This case highlights the persistent risk of malignancy from historical Thorotrast use.
• CT imaging serves as a valuable tool for detecting latent Thorotrast accumulation and associated pathologies.
• The study underscores the importance of considering past contrast agent exposure in diagnosing late-onset cancers.