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Eur J Cardiothorac Surg 2008;33:127-129. doi:10.1016/j.ejcts.2007.09.030
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Francesco Puma
Carlo Luigi Cardini
Mark Ragusa
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Case reports

Preoperative embolization in surgical management of giant thoracic sarcomas

Francesco Pumaa,*, Carlo Luigi Cardinia, Giovanni Passalacquab, Mark Ragusaa

a Department of Thoracic Surgery, University of Perugia Medical School, Terni, Italy
b Department of Interventional Radiology, S. Maria Hospital, Terni, Italy

Received 3 August 2007; received in revised form 12 September 2007; accepted 27 September 2007.

* Corresponding author. Address: Chirurgia Toracica, Ospedale Civile S. Maria, 05100 Terni, Italy. Tel.: +39 0744 205475/476/460; fax: +39 0744 425271. (Email: francescopuma{at}aospterni.it).

We report our experience with three cases of giant, highly vascular thoracic sarcomas treated by preoperative embolization and followed, after 48 h by successful excision. With this technique, reduction in tumor size was obtained, ranging from 20% to 32%; perilesional edema facilitated surgical dissection of the mass from the adjacent structures in all cases. Piecemeal removal of the tumor was carried out in two patients with minimal blood loss. In one patient an oligosymptomatic microembolization of the left upper limb was observed with symptoms spontaneously subsiding within 48 h. Preoperative embolization of giant thoracic sarcomas is useful to decrease perioperative blood loss and to facilitate surgery. In huge, highly vascular tumors, preoperative embolization may be essential in order to achieve total excision, especially if piecemeal removal is required.

Key Words: Sarcoma • Thoracic tumors • Preoperative care • Surgery






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Copyright © 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.