Injection-Site Granulomas Resulting from the Administration of Both Leuprorelin Acetate and Goserelin Acetate for the Treatment of Prostatic Cancer

Shiota, Masaki; Tokuda, Noriaki; Kanou, Takehiro; Yamasaki, Humio

doi:10.1272/jnms.74.306

Cited by 14 publications

(15 citation statements)

References 4 publications

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“…Leuprolide acetate is rarely a reported cause of cutaneous drug eruption. The most common adverse dermatologic manifestation due to leuprolide consists of subcutaneous granulomas at the site of drug injection . Histopathologically, sarcoidal‐type granulomas have been noted with multinucleated giant cells containing lipid‐like droplets .…”

Section: Discussionmentioning

confidence: 99%

Follicular mucinosis and mycosis‐fungoides‐like drug eruption due to leuprolide acetate: a case report and review

Shalin

Brantley²,

Diwan

2012

J Cutan Pathol

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Leuprolide acetate represents a gonadotropin-releasing hormone agonist, used as part of the treatment of prostate cancer. We report an unusual case of disseminated urticarial rash following leuprolide injection in a 67-year-old man that histopathologically and immunohistochemically resembled mycosis-fungoides, including the presence of follicular mucinosis and eosinophils in the follicles. This histopathologic pattern has not been previously described as a drug reaction pattern due to leuprolide, and it underscores the importance of correlation with the clinical impression to arrive at a correct diagnosis.

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Section: Discussionmentioning

confidence: 99%

Follicular mucinosis and mycosis‐fungoides‐like drug eruption due to leuprolide acetate: a case report and review

Shalin

Brantley²,

Diwan

2012

J Cutan Pathol

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“…Injection-site granuloma is associated with insulin and aluminum-containing tetanus toxoid vaccines [3]. Injections of LHRH analogue rarely cause skin lesion-mimicking metastasis of prostatic cancer [4-6]. In this case, histological and immunohistochemical analysis of the lesions at the injection sites ruled out skin metastasis and infection by microorganisms.…”

Section: Discussionmentioning

confidence: 99%

Bilateral injection-site granuloma by subcutaneous administration of luteinizing hormone-releasing hormone analogue: a case report

Kitazawa

Yamamichi²,

Hidaka³

et al. 2009

Cases J

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We report a typical case of injection-site granuloma attributed to subcutaneous administration of leuprorelin acetate, an LHRH agonist. A 70-year-old man who had undergone total prostatectomy and was subsequently given leuprorelin injections for prostatic cancer presented with bilateral nodules in the lower abdominal wall. An excisional biopsy revealed a non-caseous epithelioid granuloma consisting of CD-68 positive histiocytic cells with infiltration of T-lymphocytes and eosinophils; skin metastasis from prostatic adenocarcinoma was ruled out through histological and immunohistochemical analysis. Generally, granulomas may be caused by delayed-type hypersensitivity to the constituents of leuprorelin acetate injections.

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“…Although we identified no reports of torsades de pointes with GnRH agonists and GnRH agonists do not seem to increase cardiovascular mortality in men with locally advanced prostate cancer [77], the findings on QT interval warrant an assessment of the risks and benefits of hormonal therapy in patients with baseline QT value >450 ms and who are taking Class IA or III anti-arrhythmics [76]. Case reports have described the occurrence of granulomas at the injection site with GnRH agonist injections [78][79][80][81][82], which may be due to the GnRH analogue itself or to another constituent of the formulation [83]. Pituitary apoplexy [84][85][86], interstitial pneumonitis [87], and anaphylaxis [88] have also all been reported after GnRH agonist administration.…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

Bolton

Lynch

2018

BJU International

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To review direct comparative studies of the gonadotrophin-releasing hormone (GnRH) agonists goserelin, triptorelin, and leuprorelin for the treatment of prostate cancer, and identify whether there are meaningful clinical differences between these agents. In June 2017, the following searches were performed independently by two reviewers in PubMed: (i) 'prostate cancer' and 'triptorelin' and 'leuprorelin', (ii) 'prostate cancer' and 'triptorelin' and 'goserelin', and (iii) 'prostate cancer' and 'goserelin' and 'leuprorelin', without time restriction. Duplicates were deleted. Relevant conference abstracts were also screened. A total of 16 direct comparative trials were identified: 12 reported on efficacy outcomes, four on safety/tolerability, and five on the convenience of administration/user perceptions. These studies are restricted in terms of patient numbers, formulations assessed, and endpoints measured; none were adequately powered for survival outcome measures. Studies reporting on efficacy endpoints did not show major differences in the ability of these GnRH agonists to reduce levels of testosterone or prostate-specific antigen. Some studies suggest differences in short- or long-term testosterone control, the rate of injection site adverse events, and patient/healthcare professional perceptions, but definitive conclusions cannot be drawn from the existing evidence. Few direct comparative trials of GnRH agonists have been conducted. Whilst GnRH agonists provide a similar castration effect, there is not enough evidence to show that GnRH agonists are equivalent.

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Injection-Site Granulomas Resulting from the Administration of Both Leuprorelin Acetate and Goserelin Acetate for the Treatment of Prostatic Cancer

Cited by 14 publications

References 4 publications

Follicular mucinosis and mycosis‐fungoides‐like drug eruption due to leuprolide acetate: a case report and review

Follicular mucinosis and mycosis‐fungoides‐like drug eruption due to leuprolide acetate: a case report and review

Bilateral injection-site granuloma by subcutaneous administration of luteinizing hormone-releasing hormone analogue: a case report

Are all gonadotrophin‐releasing hormone agonists equivalent for the treatment of prostate cancer? A systematic review

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