title: [Giant subcutaneous hematoma with hemorrhagic shock induced by goserelin acetate injection for prostate cancer : report of a case].
abstract: A 87-year-old man was diagnosed with prostate cancer (cT2aN0M0 Gleason score 4＋4 with initial prostate specific antigen of 23.4 ng/ml). Prostate cancer was treated with combined androgen blockade (goserelin acetate plus flutamide). He was administered goserelin acetate depot injection without any complications as an outpatient. However, 5 hours after he left the hospital, he came back to the hospital, complaining of lower abdominal pain. Abdominal computed tomography revealed a giant subcutaneous hematoma in the lower abdomen. Hemoglobin was 6.9 g/dl and blood pressure was lower than 80 mmHg. He was admitted and given a blood transfusion. Because of pre-disseminated intravascular coagulation score 6, it was hard to antagonize warfarin by Vitamin K (he had taken warfarin because of atrial fibrillation). Arteriography was performed and injury to a branch of the lower epigastric artery was found. Transcatheter arterial embolization was performed at the same time. Injecting goserelin acetate may cause severe arterial injury.
authors.affiliation: The Department of Urology, (the) Third Hospital of Jikei University School of Medicine, The Department of Urology, Jikei University School of Medicine.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Tashiro
authors.affiliation: The Department of Urology, (the) Third Hospital of Jikei University School of Medicine.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kimura
authors.affiliation: The Department of Urology, (the) Third Hospital of Jikei University School of Medicine.
authors.forename: Takehito
authors.initials: T
authors.lastname: Naruoka
authors.affiliation: The Department of Urology, (the) Third Hospital of Jikei University School of Medicine.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Furuta
authors.affiliation: The Department of Urology, Jikei University School of Medicine.
authors.forename: Shin
authors.initials: S
authors.lastname: Egawa
mesh_terms: D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D017273:Goserelin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006406:Hematoma / Q000139:chemically induced* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy; D011859:Radiography; D012771:Shock, Hemorrhagic / Q000139:chemically induced* / Q000000981:diagnostic imaging
chemical_list: D018931:Antineoplastic Agents, Hormonal; D017273:Goserelin