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Vocal cord paralysis occurring 17 years after extravasation of Thorotrast in the neck

Department of Diagnostic Radiology, St. Thomas' Hospital, London, S.E.1

This excerpt was created in the absence of an abstract.

It is well known that the intravascular injection of Thorotrast (a 25 per cent solution, by volume, of colloidal thorium dioxide in a dextrin medium) may be followed by the development of fibrosis and malignant tumours in the liver and spleen and aplastic anaemia owing to the retention of the radioactive ²³²Th and its daughter products in the reticulo-endothelial system. Thorotrast granulomata may also occur, due to the local extravasation of Thorotrast into the tissues, though they are very uncommon in this country. For these reasons this preparation is hardly ever used as a contrast medium at the present time. This report describes a case where the extravasation of Thorotrast in the neck at carotid arteriography resulted in paralysis of the ipsilateral vocal cord. Other sites where the accidental injection of Thorotrast into the tissues has been followed by granuloma formation include the breast after mammography (More, 1940), the groin after femoral arteriography (Ziffren, 1940) and the elbow after attempted intravenous injections and brachial arteriography (Fleming and Chase, 1936, Prezyna, Ayres and Mulry, 1953).

The patient, a woman aged 51, was first seen at St. Thomas' Hospital on 2.2.1961. She complained of hoarseness for the past month. On examination the right vocal cord was paralysed.

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