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Tytuł pozycji:

Successful Transcatheter Arterial Embolization to Control Intratumoral Hemorrhage in Clear-Cell Sarcoma of the Kidney.

Tytuł:
Successful Transcatheter Arterial Embolization to Control Intratumoral Hemorrhage in Clear-Cell Sarcoma of the Kidney.
Autorzy:
Uchimura R; Department of Pediatrics, Nippon Medical School Hospital.
Ueda T; Department of Pediatrics, Nippon Medical School Hospital.
Takahashi T; Department of Pediatric Surgery, Nippon Medical School Musashikosugi Hospital.
Tanabe Y; Department of Pediatrics, Nippon Medical School Hospital.
Itabashi T; Department of Pediatrics, Nippon Medical School Hospital.
Maeda M; Department of Pediatrics, Nippon Medical School Hospital.
Itoh Y; Department of Pediatrics, Nippon Medical School Hospital.
Źródło:
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi [J Nippon Med Sch] 2022 May 12; Vol. 89 (2), pp. 233-237. Date of Electronic Publication: 2021 Mar 09.
Typ publikacji:
Case Reports; Journal Article
Język:
English
Imprint Name(s):
Original Publication: Tokyo : Medical Association of Nippon Medical School, 2000-
MeSH Terms:
Embolization, Therapeutic*/methods
Kidney Neoplasms*/complications
Kidney Neoplasms*/therapy
Sarcoma*/complications
Sarcoma*/therapy
Child ; Female ; Hemorrhage/etiology ; Hemorrhage/therapy ; Humans ; Kidney/diagnostic imaging ; Male ; Renal Artery
Contributed Indexing:
Keywords: anemia; clear cell sarcoma of the kidney; hemorrhage; transcatheter arterial embolization
Entry Date(s):
Date Created: 20210311 Date Completed: 20220516 Latest Revision: 20220516
Update Code:
20240105
DOI:
10.1272/jnms.JNMS.2022_89-108
PMID:
33692305
Czasopismo naukowe
Clear-cell sarcoma of the kidney (CCSK) is a rare, aggressive pediatric renal tumor. Intratumoral hemorrhage and tumor rupture are oncologic emergencies requiring a rapid and appropriate response. An 11-year-old boy visited our hospital with abdominal distension of 1 month's duration. Computed tomography (CT) revealed a tumor in the left kidney (size: 200 mm), and analysis of a biopsy specimen confirmed a diagnosis of CCSK. Chemotherapy was initiated to shrink the large, densely vascularized tumor before surgical removal. Two days after starting chemotherapy, the patient developed abdominal and back pain, anemia, and hypotension. CT scanning showed intratumoral bleeding. Emergency transcatheter arterial embolization (TAE) was performed to control the bleeding. Three tumor feeding vessels were identified: an ascending branch from the celiac artery, an intermediate branch from the left renal artery, and a descending branch from the inferior mesenteric artery, of which the intermediate and descending branches were large and bleeding profusely. Therefore, the intermediate branch was injected with ethanol, and the descending branch was treated by gel-foam embolization. Chemotherapy was resumed, and the patient's condition gradually stabilized. The tumor began to shrink, and subsequent chemotherapy progressed well. In week 12 of chemotherapy, the patient underwent tumor resection and left nephrectomy. Postoperative chemotherapy was completed without complications, and there was no recurrence during a 6-year follow-up period. Therefore, TAE can effectively control intratumoral bleeding in pediatric solid tumors, thus preventing high-risk open surgery.

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