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04 July 2017 : Case report  

Salvage Embolization and Histologic Analysis of Gastric Cancer with Hemorrhagic Shock Using Spherical Embolic Material

Norifumi Kennoki1ABCDEF*, Toru Saguchi2EF, Jun Otaka2EF, Yosuke Makuuchi3EF, Takafumi Watanabe4EF, So Katayanagi3EF, Hiromi Serizawa5EF, Kiyoshi Koizumi1EF, Koichi Tokuuye2EF

DOI: 10.12659/PJR.901602

Pol J Radiol 2017; 82:364-370

Abstract

BACKGROUND: In a recent study, it was reported that transcatheter arterial embolization with spherical embolic material for life-threatening hemorrhages in various cancer patients was safe and effective. Calibrated microspheres are able to access distal regions of the target arteries, which results in the disappearance of tumor staining. However, there are few reports on the pathological behavior of EmboSpheres in gastric cancer specimens. In this case, we succeeded in salvage embolization for advanced gastric cancer with hemorrhagic shock using spherical embolic material. To our knowledge, this is the first report of a pathological evaluation of spherical embolic microspheres in a gastric cancer specimen.

CASE REPORT: A 70-year-old man with scirrhous gastric cancer was admitted to our hospital for staging laparoscopy. Unfortunately, he had a sudden onset of hematemesis and melena leading to hemorrhagic shock due to bleeding from the gastric cancer. While undergoing a rapid blood transfusion, he underwent emergent embolization to achieve hemostasis. The left gastric and right gastroepiploic arteries were embolized with spherical embolic material, and the patient survived. Two days later, the patient was able to undergo gastrectomy. A large number of microspheres were observed in areas of hemorrhage. The range and median diameter of the minor axis were 177–1048 µm and 281 µm, respectively.

CONCLUSIONS: Transcatheter arterial embolization using spherical embolic material could become one of safe and effective options, especially when there is no extravasation or pseudoaneurysm but only tumor staining from the clinical and pathological point of view.

Keywords: Catheterization, Peripheral, Embolization, Therapeutic, Hemostasis, Microspheres, Stomach Neoplasms

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750