Radiation-Induced Side Effects to the Skin Due to 177Lu-PSMA Extravasation

We report a case with clinical side effects related to extravasation of 177Lu-PSMA (estimated activity of 2.25 GBq) after administration via the cubital vein. After initial cooling (±10 min), the patient was asked to elevate and mobilize the arm. Five weeks post-injection (p.i.), the patient reported localized pruritus. An erythematosqualous plaque with lichenification was observed. At 9 weeks p.i., a slight inflammatory hyperpigmentation remained; all other symptoms had disappeared.