A report of renal artery embolization for hematuria facilitating neoadjuvant chemotherapy in an unresectable malignant renal rhabdoid tumor

Sharma, Ruchika; Kitchen, Brenda J.; Mody, Rajen; Chamdin, Aghiad; Bruch, Steven W.; Jasty, Rama

doi:10.1007/s00383-013-3260-5

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…A pediatric case report highlighted the successful application of renal artery embolization in addressing hematuria associated with a malignant rhabdoid tumor of the kidney. [ 2 ] Another study reported that six pediatric patients with malignancies (three with hemorrhagic cystitis, two with procedure-related internal iliac artery injuries, and one with a tumor rupture) underwent arterial embolization. Five of these patients were successfully treated without complications.…”

Section: Discussionmentioning

confidence: 99%

Emergency Angioembolization for Life-Threatening Haemorrhage in Wilms Tumour

Salim,

Ali,

Sheikh

et al. 2023

J Cancer Allied Spec

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Introduction: Renal artery embolization has been used in a palliative fashion for symptomatic relief of hematuria or flank pain in unresectable renal cell carcinoma in adults. There is limited data on using embolization for actively bleeding and unresectable tumours in the oncological pediatric population. Case description: A previously healthy, five-year-old boy with no significant past medical or surgical history presented to the clinic with gradually worsening abdominal distension associated with occasional abdominal pain, gross hematuria, and lethargy for four months. Diagnostic investigations showed an 18 cm left-sided metastatic (pulmonary) renal tumour (Wilms), which was deemed unresectable on imaging. Treatment was planned on SIOP-RTSG protocol. However, he became hemodynamically and vitally unstable with acute sudden distension of the abdomen on the left side after the first cycle of chemotherapy. Imaging showed active bleeding from an inferior branch of the left renal artery. Selective angioembolization was done, and chemotherapy was reinitiated with a patent left main renal artery. Following the fourth cycle of chemotherapy, he developed hemodynamic instability and abdominal pain; imaging revealed the resolution of pulmonary nodules and bleeding from the left renal artery (main); this was again embolized, and the patient was stabilized. The patient was operated on after optimization and complete resection of the mass was done with negative margins. On six months follow up, he is well. Practical implications: To the best of our knowledge, this is the first case where angioembolization has been done in conjunction with neoadjuvant chemotherapy to downsize a Wilms Tumor to achieve favourable outcomes. Continued research efforts are necessary to optimize strategies and improve the prognosis for pediatric patients, and this case is one of the prime examples.

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Section: Discussionmentioning

confidence: 99%

Emergency Angioembolization for Life-Threatening Haemorrhage in Wilms Tumour

Salim,

Ali,

Sheikh

et al. 2023

J Cancer Allied Spec

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“…Transarterial embolization can be considered a safe primary option for symptomatic or larger AML (Anis et al 2020). In patients with hematuria from renal tumors, such as, malignant rhaboid tumor, embolization can be performed to stop bleeding and facilitate chemotherapy (Sharma et al 2013).…”

Section: Renal and Suprarenal Tumorsmentioning

confidence: 99%

Endovascular approaches in pediatric interventional oncology

Shaikh

Muñoz

2021

CVIR Endovasc

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The demand for interventional oncological (IO) treatment of pediatric cancers is becoming increasingly common, at least at several tertiary care institutions. The data and techniques used in pediatric IO are largely extrapolated from experience in adult patients. The management of pediatric tumors differs from that in adults in several categories, such as, the curative intent of treatment, wide use of general anesthesia, aggressive pain management, potentially longer hospital stay, variation in chemotherapy dosing etc. Additionally, pediatric cancers are managed by protocols directed by national and international oncology groups such as the Children’s Oncology Group (COG). Consequently, the translation and adoption of these techniques is gradual, but there is a noticeable uptrend due to the growing need. This review will update the current endovascular IO treatments for common pediatric liver, renal, bone and soft tissue tumors.

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