Transcatheter Arterial Embolization for Shock Caused by Intratumoral Hemorrhaging in Neurofibromatosis Type 1: A Report of Two Cases
A 33-year-old woman developed a huge pseudoneuroma in her right thigh; she had undergone six tumor resection operations and an above-the-knee amputation. Suddenly, she complained of pain in her right thigh. Her blood pressure was 89/77 mm Hg, and her pulse rate was 128 beats/min. Severe pain and swelling developed in her right thigh (fig. ). Her blood pressure was immediately increased by fluid administration. A contrast-enhanced CT imaging showed an aneurysm, which had ruptured, resulting in a huge intratumoral hemorrhage (fig. ). We immediately performed TAE, and extravasation of contrast material was detected in the peripheral branches of the lateral circumflex femoral artery (fig. ). We embolized the contrast material leakage sites by injecting an emulsion of n-butyl-2-cyanoacrylate and iodized oil at a ratio of 1:4 (Histoacryl/Lipiodol). After the TAE had been completed, the patient's blood hemoglobin level fell to 6.2 g/dl, but it was successfully restored via the transfusion of two units of erythrocytes. The patient was discharged without complications.