Successful management of bulky osseous metastasis of renal cell carcinoma with selective arterial embolization and radiofrequency ablation: a case report

Emmanouilides, Christos; Chourmouzi, Danai; Dedes, Ioannis; Pantoleon, Dimitrios; Mantziari, Polikseni; Drevelengas, Antonios

doi:10.4076/1757-1626-2-6484

Cited by 5 publications

(9 citation statements)

References 10 publications

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“…The resection of spinal mRCC metastases, which are frequently hypervascular, is associated with the potential for substantial intraoperative blood loss and massive transfusion requirement. [75][76][77] For patients who have mRCC involving the liver, transarterial embolization has been proposed as an alternative to partial hepatectomy for those with disease that progresses on immunotherapy and targeted therapy. Intraoperative blood loss in those who received embolization ranged from 1785 to 6756 mL compared with 2895 to 4827 mL in controls.…”

Section: Embolizationmentioning

confidence: 99%

“…A reduction in intraoperative blood loss with preoperative embolization of mRCC to the spine before operative resection has been supported by other case reports and small case series that also demonstrated decreased operative time. [75][76][77] For patients who have mRCC involving the liver, transarterial embolization has been proposed as an alternative to partial hepatectomy for those with disease that progresses on immunotherapy and targeted therapy. 78 Yttrium-90 glass-microsphere radioembolization has been associated with a complete radiographic response in 16 of 17 patients.…”

Section: Embolizationmentioning

confidence: 99%

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Role of metastasis‐directed treatment in kidney cancer

Psutka

Master

2018

Cancer

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Despite the rapid elaboration of multiple, novel systemic agents introduced for metastatic renal cell carcinoma (mRCC) in recent years, a durable complete response remains elusive with systemic therapy alone. Definitive treatment of the metastatic deposit remains the sole potentially curative option and is a cornerstone of mRCC therapy, offering potential for both local control and palliation of tumor-related symptoms. In this review, the evidence supporting the definitive treatment of mRCC is examined and summarized, including the use of surgical metastasectomy, thermal ablation, radiotherapy, and other minimally invasive options. Multimodal approaches, including the combination of metastasectomy with novel systemic agents, are discussed. Finally, the authors review considerations for patient selection for this type of therapy and summarize available risk-stratification tools that may help guide shared decision making.

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Section: Embolizationmentioning

confidence: 99%

Section: Embolizationmentioning

confidence: 99%

Role of metastasis‐directed treatment in kidney cancer

Psutka

Master

2018

Cancer

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“…More than 60% of skeletal metastases, including those to the spine, demonstrate hypervascularity and neovascularity. Efforts have been made to decrease the incidence of intra-operative hemorrhage [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have since reported on selective and super-selective intra-arterial embolization as an effective treatment with a rapid reduction in pain and tumor volume of primary bone and soft tissue tumors, including bony metastases from various primary malignancies. Embolization provides for devascularization, size reduction, calcification of margins, and pain relief; it can be palliative or adjunctive, as well as primary or serial [ 2 , 6 – 9 ].…”

Section: Discussionmentioning

confidence: 99%

Selective embolization for hypervascular metastasis from differentiated thyroid cancer: a case series

Son

Kim

et al. 2014

J Med Case Reports

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IntroductionThe technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage, and for benign and malignant tumors. Some hypervascular skeletal metastases are prone to massive hemorrhage.Case presentationWe describe the cases of two patients with thyroid carcinoma presenting with neuromuscular symptoms due to large skeletal metastases in the shoulder and sternum respectively. Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam. The procedures were technically successful in both patients without adverse effects or bleeding. Complete resections of the skeletal metastases were then performed without substantial bleeding.ConclusionSelective embolization is an effective treatment for bony metastases from thyroid cancer.

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“…[7][8][9] Several reports described preoperative transcatheter arterial embolization as a treatment for bone metastases from hypervascular tumors such as renal cell carcinoma and thyroid carcinoma. 5,[10][11][12][13][14][15] In renal cell carcinoma, preoperative transcatheter arterial embolization has been shown to help in obtaining adequate surgical margins and durable skeletal reconstruction and lowering patient morbidity because it decreases intraoperative blood loss. [12][13][14][15] Because of the high incidence of hepatocellular carcinoma in Asian countries, the prolonged patient survival time, and the consequent increase in the detection of metastases, appropriate treatment strategies are relevant.…”

Section: Preoperative Embolization For Bone Metastasis From Hepatocelmentioning

confidence: 99%

Preoperative Embolization for Bone Metastasis From Hepatocellular Carcinoma

Kim

Han

Jae³

et al. 2015

Orthopedics

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Preoperative transcatheter arterial embolization for hypervascular bone tumors is now widely accepted as a safe and effective procedure for reducing intraoperative blood loss and surgical morbidity. However, few studies have reported the use of preoperative transcatheter arterial embolization for nonspine bone metastases from hepatocellular carcinoma. The goal of this study was to assess the effect of preoperative embolization on blood loss and clinical outcomes in surgery for nonspine bone metastasis from hepatocellular carcinoma. Seventy-five patients with metastases from hepatocellular carcinoma to the pelvis and extremities were reviewed retrospectively. The study population consisted of 62 men and 13 women, with a mean age of 64.6 years (range, 40.0-80.1). The average follow-up period was 8.2 months (range, 0.3-66.1). Twenty-two patients underwent transcatheter arterial embolization for preoperative devascularization (group A), and 53 patients underwent operative treatment only (group B). The proportion of pelvis metastases was significantly higher (P<.001) and operative time was longer (P=.006) in group A than in group B. However, a significantly smaller decrease in hemoglobin level before and after surgery was seen in group A (P=.017). No significant differences were seen in intraoperative estimated blood loss, perioperative hemoglobin level, number of allogeneic transfusions, or length of hospitalization between the 2 groups. Preoperative transcatheter arterial embolization is an effective means to reduce bleeding during surgery for nonspine metastases from hepatocellular carcinoma. In general, surgical procedures that included transcatheter arterial embolization took longer and were more extensive.

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Successful management of bulky osseous metastasis of renal cell carcinoma with selective arterial embolization and radiofrequency ablation: a case report

Cited by 5 publications

References 10 publications

Role of metastasis‐directed treatment in kidney cancer

Role of metastasis‐directed treatment in kidney cancer

Selective embolization for hypervascular metastasis from differentiated thyroid cancer: a case series

Preoperative Embolization for Bone Metastasis From Hepatocellular Carcinoma

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