Autopsy case of double carcinoma arising from Thorotrast administrated patient

We report the pathologic and radiologic observations at autopsy of an 85-year-old man with Thorotrastosis due to angiography performed at age 37, and with double carcinoma comprising renal pelvic and gastric carcinoma. Thorotrast deposits were found in the liver, spleen, lymph nodes and bone marrows; the liver showed Thorotrast-induced cirrhosis. Renal pelvic carcinoma and gastric carcinoma were histologically squamous cell carcinoma and tubular adenocarcinoma, moderately differentiated, respectively. Renal pelvic carcinoma had metastasized to the lungs and lymph nodes. On the other hand, no metastasis of gastric carcinoma was detected. These neoplasms seemed unlikely to be in direct association with Thorotrast because there was no Thorotrast deposit in the primary sites. However, there seems to be an intense correlation between Thorotrast carcinogenicity and histologic type of the tumor, because squamous cell carcinoma of the renal pelvis is more frequent in patients with retrograde pyelography with Thorotrast than without Thorotrast. It should be kept in mind that the incidence of carcinoma due to either direct or indirect influence of Thorotrast is high in these patients. (author)