Arterial embolization in the management of connective tissue tumours
A 59-year-old woman (see ) presented with a very large mass in the right gluteal region which had grown rapidly over the past five months. The mass was painful and overlying skin was tightly stretched with areas of bruising; see for imaging and histological details. The tumour was considered surgically inoperable owing to size, risk of bleeding and likelihood of recurrence.\nThe patient therefore underwent selective arterial catheterization and embolization (SACE) via a left femoral approach. Pre-embolization angiography revealed the mass was supplied by branches of the posterior division of the internal iliac and lateral circumflex femoral (LCF) arteries. The superior gluteal artery and its branches were embolized using polyvinyl alcohol (PVA) particles until a pruned tree appearance was obtained; two metallic coils were also deployed. Ascending branches of the LCF artery were then catheterized and embolized using PVA particles and metallic coils. Owing to multiple feeding vessels, embolization of all vessels at a single procedure was considered impossible. However, successful palliation of symptoms was achieved, and the patient died later of disease progression.