Download PDF
Semin intervent Radiol 2009; 26(3): 262-269
DOI: 10.1055/s-0029-1225667
© Thieme Medical Publishers

Embolization of Nonliver Visceral Tumors

Paul G. Thacker1 , Jeremy L. Friese1 , Matthew Loe1 , Peter Biegler1 , Michael Larson1 , James Andrews1
  • 1Vascular and Interventional Radiology, Mayo Clinic, Rochester, Minnesota
Further Information

Publication History

Publication Date:
12 August 2009 (online)

Also available at
    Permissions and Reprints

ABSTRACT

Catheter-directed embolization of visceral tumors, with the exception of the liver, has received limited attention in the literature. The visceral arterial anatomy can be complex and its understanding is critical for procedure planning and limiting complications. Embolization of splenic neoplasms is exceedingly rare. Preoperative embolization for adrenal, renal, and gut tumors plays an important role in select patients. Embolization has been used successfully in the treatment of pancreatic insulinomas and in limited cases of unresectable pancreatic adenocarcinomas. Embolization of bleeding visceral tumors can be accomplished with a high likelihood of success.

KEYWORDS

Tumor - embolization - visceral

REFERENCES

  • 1 Uflacker R. Atlas of Vascular Anatomy: An Angiographic Approach. 2nd ed. Philadelphia; Lippincott Williams & Wilkins 2007: 905
    Google Scholar
  • 2 Kadir S. Atlas of Normal and Variant Angiographic Anatomy. 1st ed. Philadelphia; WB Saunders 1991: 541
    Google Scholar
  • 3 Kaufman J A, Lee M J. Vascular and Interventional Radiology: The Requisites. 1st ed. Philadelphia; Mosby 2004: 510
    Google Scholar
  • 4 Rott G, Biggemann M, Pfohl M. Embolization of an insulinoma of the pancreas with trisacryl gelatin microspheres as definitive treatment.  Cardiovasc Intervent Radiol. 2008;  31(3) 659-662
    CrossrefPubMedGoogle Scholar
  • 5 Moore T J, Peterson L M, Harrington D P, Smith R J. Successful arterial embolization of an insulinoma.  JAMA. 1982;  248(11) 1353-1355
    CrossrefPubMedGoogle Scholar
  • 6 Uflacker R. Arterial embolization as definitive treatment for benign insulinoma of the pancreas.  J Vasc Interv Radiol. 1992;  3(4) 639-644 discussion 644-646
    CrossrefPubMedGoogle Scholar
  • 7 Homma H, Doi T, Mezawa S et al.. A novel arterial infusion chemotherapy for the treatment of patients with advanced pancreatic carcinoma after vascular supply distribution via superselective embolization.  Cancer. 2000;  89(2) 303-313
    CrossrefPubMedGoogle Scholar
  • 8 Kondo S, Katoh H, Shimizu T et al.. Preoperative embolization of the common hepatic artery in preparation for radical pancreatectomy for pancreas body cancer.  Hepatogastroenterology. 2000;  47(35) 1447-1449
    PubMedGoogle Scholar
  • 9 Naritaka Y, Shiozawa S, Shimakawa T et al.. Transradial approach for partial splenic embolization in patients with hypersplenism.  Hepatogastroenterology. 2007;  54(78) 1850-1853
    PubMedGoogle Scholar
  • 10 Shah R, Mahour G H, Ford E G, Stanley P. Partial splenic embolization. An effective alternative to splenectomy for hypersplenism.  Am Surg. 1990;  56(12) 774-777
    PubMedGoogle Scholar
  • 11 Bárcena R, Gil-Grande L, Moreno J et al.. Partial splenic embolization for the treatment of hypersplenism in liver transplanted patients with hepatitis C virus recurrence before peg-interferon plus ribavirin.  Transplantation. 2005;  79(11) 1634-1635
    CrossrefPubMedGoogle Scholar
  • 12 Chikamori F, Kuniyoshi N, Kawashima T, Takase Y. Short-term portal hemodynamic effects of partial splenic embolization for hypersplenism.  Hepatogastroenterology. 2007;  54(78) 1847-1849
    PubMedGoogle Scholar
  • 13 Firat A, Boyvat F, Moray G, Aytekin C, Karakayali H, Haberal M. Comparison of two different percutaneous splenic artery interventions in the treatment of hypersplenism: preliminary report.  Transplant Proc. 2005;  37(2) 1094-1098
    CrossrefPubMedGoogle Scholar
  • 14 Sakata K, Hirai K, Tanikawa K. A long-term investigation of transcatheter splenic arterial embolization for hypersplenism.  Hepatogastroenterology. 1996;  43(7) 309-318
    PubMedGoogle Scholar
  • 15 Sockrider C S, Boykin K N, Green J et al.. Partial splenic embolization for hypersplenism before and after liver transplantation.  Clin Transplant. 2002;  16(Suppl 7) 59-61
    CrossrefPubMedGoogle Scholar
  • 16 Zhu K, Meng X, Li Z et al.. Partial splenic embolization using polyvinyl alcohol particles for hypersplenism in cirrhosis: a prospective randomized study.  Eur J Radiol. 2008;  66(1) 100-106
    CrossrefPubMedGoogle Scholar
  • 17 O'Halpin D, Legge D, MacErlean D P. Therapeutic arterial embolisation: report of five years' experience.  Clin Radiol. 1984;  35(2) 85-93
    CrossrefPubMedGoogle Scholar
  • 18 Basile A, Certo A, Ascenti G, Lamberto S, Cannella A, Medina J G. Interventional radiology in the preoperative management of stromal tumors causing intestinal bleeding.  Radiol Med (Torino). 2003;  106(4) 376-381
    PubMedGoogle Scholar
  • 19 Kurihara N, Kikuchi K, Tanabe M et al.. Partial resection of the second portion of the duodenum for gastrointestinal stromal tumor after effective transarterial embolization.  Int J Clin Oncol. 2005;  10(6) 433-437
    CrossrefPubMedGoogle Scholar
  • 20 Joyce D L, Hong K, Fishman E K, Wisell J, Pawlik T M. Multi-visceral resection of pancreatic VIPoma in a patient with sinistral portal hypertension.  World J Surg Oncol. 2008;  6 80
    CrossrefPubMedGoogle Scholar
  • 21 Lee E W, Laberge J M. Differential diagnosis of gastrointestinal bleeding.  Tech Vasc Interv Radiol. 2004;  7(3) 112-122
    CrossrefPubMedGoogle Scholar
  • 22 Goldstein H M, Medellin H, Ben-Menachem Y, Wallace S. Transcatheter arterial embolization in the management of bleeding in the cancer patient.  Radiology. 1975;  115(3) 603-608
    PubMedGoogle Scholar
  • 23 Kickuth R, Rattunde H, Gschossmann J, Inderbitzin D, Ludwig K, Triller J. Acute lower gastrointestinal hemorrhage: minimally invasive management with microcatheter embolization.  J Vasc Interv Radiol. 2008;  19(9) 1289-1296, e2
    CrossrefPubMedGoogle Scholar
  • 24 Lee H J, Shin J H, Yoon H K et al.. Transcatheter arterial embolization in gastric cancer patients with acute bleeding.  Eur Radiol. 2009;  19(4) 960-965
    CrossrefPubMedGoogle Scholar
  • 25 Seya T, Tanaka N, Yokoi K, Shinji S, Oaki Y, Tajiri T. Life-threatening bleeding from gastrointestinal stromal tumor of the stomach.  J Nippon Med Sch. 2008;  75(5) 306-311
    CrossrefPubMedGoogle Scholar
  • 26 Funaki B, Kostelic J K, Lorenz J et al.. Superselective microcoil embolization of colonic hemorrhage.  AJR Am J Roentgenol. 2001;  177(4) 829-836
    CrossrefPubMedGoogle Scholar
  • 27 Townsend C MBR, Evers B M, Mattox K L. Sabiston Textbook of Surgery. 18th ed. Philadelphia; Saunders 2008: 2100
    Google Scholar
  • 28 Inoue H, Nakajo M, Miyazono N et al.. Successful therapeutic embolization of aldosteronoma using absolute ethanol.  Radiat Med. 1993;  11(6) 256-259
    PubMedGoogle Scholar
  • 29 Inoue H, Nakajo M, Miyazono N et al.. Treatment of aldosteronoma with superselective intraarterial injection of absolute ethanol.  Nippon Igaku Hoshasen Gakkai Zasshi. 1994;  54(2) 154-162
    PubMedGoogle Scholar
  • 30 Inoue H, Nakajo M, Miyazono N, Nishida H, Ueno K, Hokotate H. Transcatheter arterial ablation of aldosteronomas with high-concentration ethanol: preliminary and long-term results.  AJR Am J Roentgenol. 1997;  168(5) 1241-1245
    PubMedGoogle Scholar
  • 31 Hokotate H, Inoue H, Baba Y, Tsuchimochi S, Nakajo M. Aldosteronomas: experience with superselective adrenal arterial embolization in 33 cases.  Radiology. 2003;  227(2) 401-406
    CrossrefPubMedGoogle Scholar
  • 32 Baguet J P, Hammer L, Tremel F, Mangin L, Mallion J M. Metastatic phaeochromocytoma: risks of diagnostic needle puncture and treatment by arterial embolisation.  J Hum Hypertens. 2001;  15(3) 209-211
    CrossrefPubMedGoogle Scholar
  • 33 Horton J A, Hrabovsky E, Klingberg W G, Hostler J A, Jenkins J J. Therapeutic embolization of a hyperfunctioning pheochromocytoma.  AJR Am J Roentgenol. 1983;  140(5) 987-988
    PubMedGoogle Scholar
  • 34 Hrabovsky E E, McLellan D, Horton J A, Klingberg W G. Catheter embolization: preparation of patient with pheochromocytoma.  J Pediatr Surg. 1982;  17(6) 849-850
    CrossrefPubMedGoogle Scholar
  • 35 Park J H, Kang K P, Lee S J, Kim C H, Park T S, Baek H S. A case of a ruptured pheochromocytoma with an intratumoral aneurysm managed by coil embolization.  Endocr J. 2003;  50(6) 653-656
    CrossrefPubMedGoogle Scholar
  • 36 Pua U, Wong D E. Transarterial embolisation of spontaneous adrenal pheochromocytoma rupture using polyvinyl alcohol particles.  Singapore Med J. 2008;  49(5) e126-e130
    PubMedGoogle Scholar
  • 37 Bunuan H D, Alltree M, Merendino K A. Gel foam embolization of a functioning pheochromocytoma.  Am J Surg. 1978;  136(3) 395-398
    CrossrefPubMedGoogle Scholar
  • 38 Inoue H, Nakajo M, Miyazono N et al.. A case with Cushing's syndrome treated with arterial ablation of adrenal gland by absolute ethanol.  Radiat Med. 1993;  11(6) 221-223
    PubMedGoogle Scholar
  • 39 Ueno K, Nakajo M, Miyazono N et al.. Transcatheter adrenal arterial embolization of cortisol-producing tumors. Two cases of Cushing's syndrome.  Acta Radiol. 1999;  40(1) 100-103
    CrossrefPubMedGoogle Scholar
  • 40 O'Keeffe F N, Carrasco C H, Charnsangavej C, Richli W R, Wallace S. Arterial embolization of adrenal tumors: results in nine cases.  AJR Am J Roentgenol. 1988;  151(4) 819-822
    PubMedGoogle Scholar
  • 41 Blunt S B, Pirmohamed M, Chatterjee V K, Burrin J M, Allison D J, Joplin G F. Use of adrenal arterial embolization in severe ACTH-dependent Cushing's syndrome.  Postgrad Med J. 1989;  65(766) 575-579
    CrossrefPubMedGoogle Scholar
  • 42 Bourlet P, Dumousset E, Nasser S et al.. Embolization of hepatic and adrenal metastasis to treat Cushing's syndrome associated with medullary thyroid carcinoma: a case report.  Cardiovasc Intervent Radiol. 2007;  30(5) 1052-1055
    CrossrefPubMedGoogle Scholar
  • 43 Townsend C M, Beauchamp R D, Evers B M, Mattox K L. Sabiston Textbook of Surgery. 18th ed. Philadelphia; Saunders 2008: 2100
    Google Scholar
  • 44 Li S H, Huang C H, Ko S F, Chou F F, Huang S C. Extended survival in a patient with recurrent and metastatic adrenal cortical carcinoma by aggressive transarterial embolization—a case report.  J Surg Oncol. 2005;  90(2) 101-105
    CrossrefPubMedGoogle Scholar
  • 45 Momoi H, Shimahara Y, Terajima H et al.. Management of adrenal metastasis from hepatocellular carcinoma.  Surg Today. 2002;  32(12) 1035-1041
    CrossrefPubMedGoogle Scholar
  • 46 Park J S, Yoon D S, Kim K S et al.. What is the best treatment modality for adrenal metastasis from hepatocellular carcinoma?.  J Surg Oncol. 2007;  96(1) 32-36
    CrossrefPubMedGoogle Scholar
  • 47 Hendrickson R J, Katzman P J, Queiroz R, Sitzmann J V, Koniaris L G. Management of massive retroperitoneal hemorrhage from an adrenal tumor.  Endocr J. 2001;  48(6) 691-696
    CrossrefPubMedGoogle Scholar
  • 48 Nakajo M, Onohara S, Shinmura K, Fujiyoshi F, Nakajo M. Embolization for spontaneous retroperitoneal hemorrhage from adrenal myelolipoma.  Radiat Med. 2003;  21(5) 214-219
    PubMedGoogle Scholar
  • 49 Yang P W, Wang W Y, Yang C H, Chou C C, Yen D H, Chou J. Treatment of massive retroperitoneal hemorrhage from adrenal metastasis of hepatoma.  J Chin Med Assoc. 2007;  70(3) 126-131
    CrossrefPubMedGoogle Scholar
  • 50 Fink I J, Girton M, Doppman J L. Absolute ethanol injection of the adrenal artery: hypertensive reaction.  Radiology. 1985;  154(2) 357-358
    PubMedGoogle Scholar
  • 51 Bono A V, Caresano A. The role of embolization in the treatment of kidney carcinoma.  Eur Urol. 1983;  9(6) 334-337
    PubMedGoogle Scholar
  • 52 Zielinski H, Szmigielski S, Petrovich Z. Comparison of preoperative embolization followed by radical nephrectomy with radical nephrectomy alone for renal cell carcinoma.  Am J Clin Oncol. 2000;  23(1) 6-12
    CrossrefPubMedGoogle Scholar
  • 53 Wallace S, Chuang V P, Swanson D et al.. Embolization of renal carcinoma.  Radiology. 1981;  138(3) 563-570
    PubMedGoogle Scholar
  • 54 Serafin Z, Karolkiewicz M, Strześniewski P, Lasek W, Bryczkowski M, Wolski Z. Palliative percutaneous kidney embolization with enbucrilate in patients with renal cell carcinoma: safety and symptom control.  Med Sci Monit. 2007;  13(Suppl 1) 98-104
    PubMedGoogle Scholar
  • 55 Lammer J, Justich E, Schreyer H, Pettek R. Complications of renal tumor embolization.  Cardiovasc Intervent Radiol. 1985;  8(1) 31-35
    CrossrefPubMedGoogle Scholar
  • 56 Roy C, Tuchmann C, Morel M, Saussine C, Jacqmin D, Tongio J. Is there still a place for angiography in the management of renal mass lesions?.  Eur Radiol. 1999;  9(2) 329-335
    CrossrefPubMedGoogle Scholar
  • 57 Munro N P, Woodhams S, Nawrocki J D, Fletcher M S, Thomas P J. The role of transarterial embolization in the treatment of renal cell carcinoma.  , [see comment] BJU Int. 2003;  92(3) 240-244
    CrossrefPubMedGoogle Scholar

Jeremy L FrieseM.D. M.B.A. 

Vascular and Interventional Radiology, Mayo Clinic

200 First Street SW, Rochester, MN, 55905

Email: friese.jeremy@mayo.edu

      >