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Pleuroperitoneal Migration of Intraperitoneal Phosphorus-32-Chromic Phosphate Therapy for Stage I Ovarian Carcinoma

Department of Radiology, Duke University Medical Center, Durham, North Carolina

Correspondence: For correspondence or reprints contact: Robert H. Wilkinson, Jr, MD, Section on Nuclear Medicine, Department of Radiology, P.O. Box 3949, Duke University Medical Center, Durham, NC 27710.

ABSTRACT

A patient with postoperative Stage I ovarian carcinoma received 15 mCi of ³²P-chromic phosphate suspension in normal saline intraperitoneally as part of her therapy. The following day, a portion of the infused radiopharmaceutical and normal saline had passed transdiaphragmatically into the patient's right pleural cavity. Thoracentesis removed as much fluid as possible and this fluid contained radioactive material. In the ensuing 4 yr, the patient has not manifested any detectable pleural or pulmonary abnormalities attributable to the radioactivity. Retrospective review of 100 consecutive patients receiving ³²P-chromic phosphate intraperitoneal therapy resulted in 43 patients in whom the hemithoraces could be evaluated scintigraphically. Three of the 43 patients (7%) had right pleural fluid radioactivity. This is similar to the percentages reported in patients with cirrhosis with ascites in whom hepatic hydrothorax is identified.

Key Words: ovarian carcinoma • phosphorus-32-phosphate pleural radioactivity • radiopharmaceutical therapy