Selective Transarterial Embolization for Refractory Bleeding in Advanced Scalp Angiosarcoma: Two Cases.
Masaaki Sakumoto, Shun Toyosato, Amiko Kayo et al.
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Case in brief
Two 75-year-old patients with advanced scalp angiosarcoma developed persistent bleeding from ulcerated, progressive tumors despite prior cancer treatment. In the man, recurrent arterial hemorrhage required transfusions; angiography showed tumor-feeding branches from the superficial temporal and angular arteries. Selective transarterial embolization achieved immediate hemostasis, although bleeding later recurred and required a second procedure. In the woman, embolization rapidly and durably controlled bleeding without major complications. The cases illustrate embolization as a means of controlling otherwise refractory tumor hemorrhage.
What made this case unusual
The bleeding was arterial and arose from ulcerated scalp tumors in patients whose disease had progressed despite chemoradiotherapy; angiography localized tumor-feeding vessels that could be selectively embolized.
Diagnostic / clinical pearl
For refractory arterial bleeding from advanced scalp angiosarcoma, angiography can identify tumor-feeding arteries for selective embolization, which may provide rapid hemostasis.
Why it matters
In selected patients, embolization may reduce the burden of local bleeding management when tumor hemorrhage is difficult to control.