Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.210005
Jornal Vascular Brasileiro
Case Report

Embolization of renal tumor bone metastasis: case report

Embolização de metástase óssea de tumor renal: relato de caso

Felipe Soares Ribeiro; Salim Abdon Haber Jeha; José Victor Figueiredo dos Santos; Ananda Vitória Suzuki Barros Damasceno; Tereza Maria Meireles Fernandes da Silva; Fernando Brasil do Couto Filho; Humberto Balbi Reale Neto

Downloads: 0
Views: 716

Abstract

Abstract: Primary or secondary bone tumors can manifest in different ways, from simple bone pain to possible pathological fractures. Hypervascularized tumors are of greatest concern, with increased incidence of complications. Preoperative embolization of the bone tumor is an effective measure for reducing blood loss during open surgery to excise the tumor. With appropriate experience, the risks of the procedure are minimal and final outcomes are highly satisfactory. The purpose of this paper is to describe the case of a 43-year-old male patient with a metastatic renal cell tumor in the left proximal femur (seen on lower limb computed tomography) who underwent selective preoperative embolization. The procedure resulted in a remarkable absence of bleeding and successful response to subsequent onco-orthopedic surgery.

Keywords

renal cell carcinoma, arterial embolization, bone metastasis

Resumo

Resumo: Os tumores ósseos, primários ou secundários, podem se manifestar de várias formas, desde dor óssea até fraturas patológicas. A preocupação maior repousa sobre tumores hipervascularizados, com maior incidência de complicações. A embolização pré-operatória do tumor ósseo é uma medida eficaz para reduzir a perda sanguínea durante a exérese tumoral em cirurgia aberta. Com uma experiência apropriada, os riscos do procedimento são mínimos, com resultados finais bastante satisfatórios. O presente artigo tem por finalidade descrever o caso de um paciente do sexo masculino, de 43 anos, com tumor metastático de células renais em fêmur proximal esquerdo (visualizado por angiotomografia de membro inferior), submetido à embolização arterial seletiva pré-operatória. O procedimento resultou em ausência de sangramento e ótima resposta à cirurgia onco-ortopédica realizada.
 

Palavras-chave

carcinoma de células renais, embolização arterial, metástase óssea

References

1 Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49(6):1374-403. http://dx.doi.org/10.1016/j.ejca.2012.12.027. PMid:23485231.

2 Tahbaz R, Schmid M, Merseburger AS. Prevention of kidney cancer incidence and recurrence: lifestyle, medication and nutrition. Curr Opin Urol. 2018;28(1):62-79. http://dx.doi.org/10.1097/MOU.0000000000000454. PMid:29059103.

3 Bianchi M, Sun M, Jeldres C, et al. Distribution of metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol. 2012;23(4):973-80. http://dx.doi.org/10.1093/annonc/mdr362. PMid:21890909.

4 Gatto L, Facchini G, Saponara M, et al. Successful selective arterial embolization for bone metastases in renal cell carcinoma integrated with systemic therapies: A case report. Radiol Case Rep. 2017;12(4):775-9. http://dx.doi.org/10.1016/j.radcr.2017.07.008. PMid:29484069.

5 Lau V, Sun M, Chu F. Embolization of hypervascular bone tumours: A pictorial essay with literature review. J oMed Imaging. Radiat Oncol. 2013;57(2):191-7. PMid:23551777.

6 Leenknegt B, Pesapane F, Huang D. Pre-Operative trans-arterial embolization of a Hypervascular bone metastasis. J Belg Soc Radiol. 2019;103(1):9. http://dx.doi.org/10.5334/jbsr.1694. PMid:30671567.

7 Mirels H. Metastatic diseases in long bones, a proposed scoring system for diagnosis impending pathologic fractures. Clin Orthop Relat Res. 1989;(249):256-64. PMid:2684463.

8 Rossi G, Mavrogenis AF, Casadei R, et al. Embolization of bone metastases from renal cancer. Radiol Med (Torino). 2013;118(2):291-302. http://dx.doi.org/10.1007/s11547-012-0802-4. PMid:22430676.

9 Owen RJ. Embolization of Musculoskeletal Bone Tumors. Semin Intervent Radiol. 2010;27(02):111-23. http://dx.doi.org/10.1055/s-0030-1253510. PMid:21629401.

10 Forauer AR, Kent E, Cwikiel WH, Esper P, Redman B. Selective palliative transcatheter embolization of bony metastases from renal cell carcinoma. Acta Oncol. 2007;46(7):1012-8. http://dx.doi.org/10.1080/02841860701280725. PMid:17851849.

11 Feldman F, Casarella WJ, Dick HM, Hollander BA. Selective intra-arterial embolization of bone tumors: A useful adjunct in the management of selected lesions. Am J Roentgenol Radium Ther Nucl Med. 1975;123(1):130-9. http://dx.doi.org/10.2214/ajr.123.1.130. PMid:1119647.

12 Van Tol KM, Hew JM, Jager PL, Vermey A, Dullaart RP, Links TP. Embolization in combination with radioiodine therapy for bone metastases from differentiated thyroid carcinoma. Clin Endocrinol (Oxf). 2000;52(5):653-9. http://dx.doi.org/10.1046/j.1365-2265.2000.00998.x. PMid:10792347.

13 Facchini G, Di Tullio P, Battaglia M, et al. Palliative embolization for metastases of the spine. Eur J Orthop Surg Traumatol. 2016;26(3):247-52. http://dx.doi.org/10.1007/s00590-015-1726-y. PMid:26667933.

14 Yu X, Xu M, Xu S, Fu Z. Long-term outcome of giant cell tumor of bone involving sacroiliac joint treated with selective arterial embolization and curettage: a case report and literature review. World J Surg Oncol. 2013;11(1):72. http://dx.doi.org/10.1186/1477-7819-11-72. PMid:23497322.

15 Lackman RD, Khoury LD, Esmail A, Donthineni-Rao R. The treatment of sacral giant-cell tumours by serial arterial embolisation. J Bone Joint Surg Br. 2002;84(6):873-7. http://dx.doi.org/10.1302/0301-620X.84B6.0840873. PMid:12211682.

16 Pazionis TJC, Papanastassiou ID, Maybody M, Healey JH. Embolization of hypervascular bone metastases reduces intraoperative blood loss: a case-control study. Clin Orthop Relat Res. 2014;472(10):3179-87. http://dx.doi.org/10.1007/s11999-014-3734-3. PMid:24964883.

17 Barton PP, Waneck RE, Karnel FJ, Ritschl P, Kramer J, Lechner GL. Embolization of bone metastases. J Vasc Interv Radiol. 1996;7(1):81-8. http://dx.doi.org/10.1016/S1051-0443(96)70738-8. PMid:8773979.
 


Submitted date:
01/20/2021

Accepted date:
04/05/2021

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
60ccd932a953957f8e43ab23 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections