Large solitary rectal ulcer as a complication of prostate brachytherapy.

摘要

A 67-year-old man was admitted with hematochezia 1 day after receiving a dose of leuprolide as an adjuvant agent for TlcNOMO prostate cancer. Treatment for his prostate cancer began 16 months earlier and consisted of external beam radiation followed by cesium-131 brachy-therapy. Eight months later, a colonoscopy was performed for anemia and was remarkable only for diverticulosis; rectal mucosa was normal (A). To determine the site of lower GI bleeding during the most recent admission, flexible sig-moidoscopy was performed and revealed a large (>3 cm),deeply-cratered rectal ulcer (B). Endoscopic biopsy specimens (C, H&E, orig. mag. x 100) showed areas of mucosal necrosis. The underlying connective tissue contained thick-walled vessels (thin arrows) and areas of dense fi-brosis.