Renal Arteries Embolization in Unresectable Clear Cell Renal Carcinoma: First Time Experience at Haji Adam Malik Hospital

Abstract

OBJECTIVE:To report a case of renal arterial embolisation (RAE) in unresectable renal tumour before nephrectomy.CASE REPORT:On presentation, the clinical features of this patient, including medical history, signs and symptoms, imaging examinations were recorded. After diagnosis and initial treatment, the result and histopathological examination were performed and discussed. We performed RAE in the unresectable renal tumour in the 28-year-old male that was complaining a palpable pain right flank mass and intermittent hematuria that had been observed five months earlier. A month after RAE, the tumour shrinks and become resectable. The parameter used was tumour volume, propulsion and component, with subjective value VAS, hematuria symptom and Quality Of Life Score EORTC-QLQ C30. The next step we performed nephrectomy with histopathology results in Clear Cell Renal Carcinoma (CCRC).CONCLUSION:RAE is an effective therapeutic and adjuvant tool because it facilitates the dissection of unresectable large renal tumours and tumours with extensive involvement around the renal hilum; it leading to lower overall morbidity. However, the lack of randomised prospective studies is the primary reason that RAE is not used often before surgery.

Efficacy and safety analysis of TACE + sunitinib vs. sunitinib in the treatment of unresectable advanced renal cell carcinoma: a retrospective study

“…J H Park et al reported [38] that for patients with inoperable RCC, TAE using lipiodol + ethanol emulsion was an effective and safe treatment. Noor Riza Perdana et al reported [39] that RAE is an effective treatment for large unresectable renal tumors and can reduce mortality. T Kato et al reported [40] that chemoembolization with mitomycin C microcapsules is a very effective treatment for renal cell carcinoma.…”

Review of the article "First experience of superselective embolization of renal arteries supplying the tumor with subsequent laparoscopic kidney resection"

“…В литературе представлен не совсем однозначный опыт применения эмболизации почечной артерии перед нефрэктомией при больших опухолях, сопровождающихся развитием массивной патологической сосудистой сети [1,2]. Это способствовало снижению объема кровопотери, однако некоторые авторы испытывали существенные технические трудности при выделении и лигировании артерии, а также с выраженным болевым синдромом и гипертермией в течение до 48 ч после процедуры [2].…”