title: [Cutaneous epithelioid granulomas caused by subcutaneous infusion of leuprorelin acetate: a case report].
abstract: A 73-year-old man presented with an ulcer and a subcutaneous nodule where he was receiving leuprorelin acetate injections to treat his prostatic carcinoma. Pathological findings of a skin biopsy showed many epithelioid granulomas with multinuclear giant cells, which contained small vacuoles. Recently, these lesions have been suggested to be caused by a type IV allergic response to the copolymer of lactic and glycolic acids used as a vehicle for drug administration. When urologists treat a prostatic adenocarcinoma with subcutaneous infusion of leuprorelin acetate, they should be aware of this potential side effect of the drug because the resulting granulomar formation may interfere with the effect of the drug. If patients suffer from subcutaneous nodules, urologists should consider changing the drug to an other type of luteinizing hormone-releasing hormone analogues such as goserelin acetate. This reaction to leuprorelin acetate has been reported in only seven cases including our case.
authors.affiliation: Division of Pathology, Hyogo Prefectual Amagasaki Hospital.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Tachibana
authors.forename: Zyun
authors.initials: Z
authors.lastname: Yamano
authors.forename: Yuzi
authors.initials: Y
authors.lastname: Kusuda
authors.forename: Shyozi
authors.initials: S
authors.lastname: Hara
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Shimogaki
authors.forename: Gaku
authors.initials: G
authors.lastname: Hamami
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D016729:Leuprolide / Q000009:adverse effects*; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology
chemical_list: D018931:Antineoplastic Agents, Hormonal; D016729:Leuprolide