Abstract
Extravasation of thorium dioxide after transcervical carotid angiography has resulted in persistent open draining neck wounds. These difficult problems have remained a challenge for the treating head and neck surgeon. Neck dissection has been the mainstay of treatment in the past; however, this has been fraught with complications. The application of doxycycline sclerosis is described in the successful resolution of a large Thorotrast granulomatous neck wound. A review of the literature and the management options of Thorotrast granulomas are discussed.
Keywords
Get full access to this article
View all access options for this article.
References
1.
Nguyen
BT
Yousem
DM
Hayden
RE
Montone
KT
. Cervical thorium dioxide granuloma (“thorotrastoma”) . AJNR Am J Neuroradiol 1995 ; 16 : 1729 –32 .
2.
Polacarz
SV
Laing
RW
Loomes
R
. Thorotrast granuloma: An unexpected diagnosis . J Clin Pathol 1992 ; 45 : 259 –61 .
3.
Stanley
RB
Jr
Calcaterra
TC
. Management of cervical thorium dioxide granulomas . Arch Otolaryngol 1981 ; 107 : 631 –4 .
4.
Stanley
RB
Jr
. Thorium-dioxide—induced pharyngeal hemorrhage . Am J Otolaryngol 1983 ; 4 : 437 –41 .
5.
Lung
RJ
Harding
RL
Herceg
SJ
Schantz
JC
Miller
SH
. Long-term survival with Thorotrast cervical granuloma . J Surg Oncol 1978 ; 10 : 171 –7 .
6.
Selesnick
SH
Sessions
RB
Urmacher
C
. Median sternotomy for cervical Thorotrast granuloma and carotid hemorrhage . Otolaryngol Head Neck Surg 1990 ; 102 : 405 –8 .
7.
Plent
S
Shah
S
Westmore
GA
. Thorotrast granuloma — A renascence . J Laryngol Otol 1990 ; 104 : 355 –7 .
8.
Wustrow
TPU
Behbehani
AA
Wiebecke
B
. Thorotrast-induced oro- and hypopharyngeal fibrosis with recurrent bleeding . J Craniomaxillofac Surg 1988 ; 16 : 315 –6 .
9.
Stougaard
M
Praestholm
J
Stoier
M
. Late effects of perivascular injection of Thorotrast in the neck . J Laryngol Otol 1984 ; 98 : 1003 –7 .
10.
Miglets
AW
Letson
JA
Speigel
JC
. Thorotrast induced pharyngeal necrosis . Ann Otol Rhinol Laryngol 1978 ; 87 : 701 –6 .
11.
Andersson
M
Carstensen
B
Storm
HH
. Mortality and cancer incidence after cerebral arteriography with or without Thorotrast . Radiat Res 1995 ; 142 : 305 –20 .
12.
Levowitz
BS
Hughes
RE
Alford
TC
. Treatment of thorium dioxide granulomas of the neck . N Engl J Med 1963 ; 268 : 340 –2 .
13.
Webber
PA
Milford
C
. Thorotrast granuloma of the neck . J R Soc Med 1984 ; 77 : 1039 –41 .
14.
Kamijo
A
Okabe
K
Hirose
T
. Thorium dioxide granuloma of the neck with resultant fatal hemorrhage . Arch Otolaryngol 1979 ; 105 : 45 –7 .
15.
Linder
EA
. Carotid artery rupture as a late effect of Thorotrast angiography . ORL J Otorhinolaryngol Relat Spec 1981 ; 43 : 309 –13 .
16.
Chalat
NI
Zane
AI
. Radical neck dissection for thorium dioxide granuloma . Arch Otolaryngol 1966 ; 83 : 610 –4 .
17.
Muzaffar
K
Nichols
RD
. Thorotrast (thorium dioxide) granuloma of the neck: Surgical considerations . Ann Otol Rhinol Laryngol 1975 ; 84 : 245 –9 .
18.
Andersson
M
Juel
K
Storm
HH
. Pattern of mortality among Danish Thorotrast patients . J Clin Epidemiol 1993 ; 46 : 637 –44 .
19.
Burrel
M
. Cervical Thorotrast granuloma: An iatrogenic cause of dysphagia . Gastrointest Radiol 1977 ; 2 : 293 –5 .
20.
DeLuca
SA
Rhea
JT
Weber
AL
. Vocal cord paralysis: A latent effect of perivascular thorium dioxide . Arch Otolaryngol 1984 ; 110 : 339 –40 .
21.
Harrist
TJ
Schiller
AL
Trelstad
RL
Mankin
HJ
Mays
CW
. Thorotrast-associated sarcoma of bone . Cancer 1979 ; 44 : 2049 –58 .
22.
Isner
JM
Sazama
KJ
Roberts
WC
. Vascular complications of thorium dioxide . Am J Med 1978 ; 64 : 1069 –74 .
23.
Winter
LE
Duvall
AJ
III
. Thorotrastomas of the neck . Ann Otol Rhinol Laryngol 1967 ; 76 : 498 –502 .
