Aberrant ovarian artery supply of uterine sarcoma: a cause of rebleeding following uterine artery embolization

Transcatheter embolization has an increasingly important role in the treatment of inoperable lifethreatening haemorrhage as a complication of advanced pelvic cancer. Usually a bleeding uterine sarcoma is supplied by branches of the internal iliac arteries. We describe a patient with massive pelvic haemorrhage due to a uterine sarcoma, that was not controlled by bilateral uterine artery embolization. Continued haemorrhage was due to a rare additional tumour blood supply arising from an aberrant ovarian artery, found on follow-up angiography and subsequently successfully embolized. This illustrates the importance of identifying other possible feeding vessels supplying pelvic tumours if bleeding is not controlled by embolization of the usual vessels supplying the organ.