Bone Metastasis from Renal Cell Carcinoma

Preoperative Embolization of Acetabular Bone Metastasis from Renal Cell Carcinoma

Clinical Background

A 70-year-old female with a history of renal cell carcinoma and prior radiation presented with a symptomatic metastatic lesion in the left hip acetabulum. The lesion was ill-defined, osteolytic in nature, and measured 5.3 cm. Embolization was pursued as a preoperative strategy to reduce intraoperative bleeding risk prior to orthopedic surgical intervention.

Baseline CT

Pre-HES Embolization Angiogram, Vessel 1

Pre-HES Embolization Angiogram, Vessels 2 and 3

Post-HES Embolization Angiogram, Vessel 1

Post-HES Embolization Angiogram, Vessels 2 and 3

Tumor Characteristics

  • Location: Left hip, acetabular region
  • Size: 5.3 cm
  • Morphology: Ill-defined, osteolytic
  • Indication: Preoperative embolization prior to hip replacement

Intervention Details

  • Approach: Transarterial Embolization with Embrace HES via transradial access
  • Vessels Treated: 3
    • Vessel 1: 2 mm – 0.6 mL
    • Vessel 2: 3 mm – 1.3 mL
    • Vessel 3: 2 mm – 1.3 mL
    • Note: Vessels 2 and 3 originated from the same trunk
  • Procedure Outcome: Successful embolization achieved

Conclusion

This case illustrates the utility of transarterial embolization with Embrace HES in the management of osseous metastases from RCC. Embolization achieved technical success and allowed the patient to undergo definitive surgical intervention with reduced perioperative risk.

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