Injection-site granulomas resulting from the administration of both leuprorelin acetate and goserelin acetate for the treatment of prostatic cancer.

Although injection-site granulomas caused by leuprorelin acetate have been reported, there have been no reports of granulomas caused by both leuprorelin acetate and goserelin acetate. An 81-year-old man presented with subcutaneous nodules of the abdominal wall and upper arm, where 11.25 mg of leuprorelin acetate had been injected for the treatment of prostate cancer. Because of these nodules, treatment was changed to goserelin acetate. Nevertheless, he presented with another subcutaneous nodule at the injection site. Histological examination showed that these nodules consisted of numerous giant cells that were CD3-positive T lymphocytes and CD68-positive histiocytes associated with granulomatous changes. The granulomas had likely been caused by delayed-type hypersensitivity to leuprorelin acetate injection. The granuloma that formed after goserelin acetate injection might thus have developed owing to the immunogenicity of the previous leuprorelin acetate injections. The patient underwent surgical castration. The present case suggests that both leuprorelin acetate and goserelin acetate can cause injection-site disorders.

Injection-site granulomas due to the administration of leuprorelin acetate for the treatment of prostatic cancer.

Luteinizing hormone-releasing hormone (LH-RH) analogues have become the main focus of androgen deprivation therapy for prostatic cancer. The occurrence of injection-site granulomas due to the administration of LH-RH analogues has been thought to be a rare reaction. We herein report a rare case presenting injection-site granuloma due to the administration of leuprorelin acetate, mimicking metastatic nodule. A 90-year-old man presented with subcutaneous nodules at the injection-site of leuprorelin acetate 11.25 mg (for 3-month use). Ultrasound examination and computed tomography (CT) revealed two nodules in the bilateral abdominal walls mimicking metastatic nodule. Although he was surgically treated because of the possibility of malignancy, in the end, no evidence of malignancy was found. We should keep in mind that LH-RH analogues may cause injection-site granulomas mimicking metastatic nodule, and therefore we must inform patients undergoing the administration of leuprorelin acetate that it may cause injection-site granuloma and thus when a patient demonstrates a subcutaneous nodule it is essential to confirm whether or not he has received an injection of the LH-RH analogue at the site of nodule.

Incidence rate of injection-site granulomas resulting from the administration of luteinizing hormone-releasing hormone analogues for the treatment of prostatic cancer.

PURPOSE: Granulomas resulting from the administration of luteinizing hormone-releasing hormone analogues (LH-RH analogues) are thought to be very rare. We report on our clinical experience with injection-site granulomas that result from the administration of LH-RH analogues, and we evaluate the incidence rate of these granulomas. MATERIALS AND METHODS: We used the clinical records of 118 patients who were administered LH-RH analogues in 2005. We describe the clinical data of patients who experienced injection-site granulomas and evaluated the incidence rate. RESULTS: Five patients demonstrated injection-site granulomas due to LH-RH analogue administration. The incidence rate was 4.2% (5 of 118 patients). Most of the granulomas occurred after the first or second administration of 11.25mg of leuprorelin acetate. CONCLUSION: The occurrence of granulomas resulting from the administration of LH-RH analogues was thought to be very rare. Our study, however, revealed a higher incidence rate than expected, especially for leuprorelin acetate.