Embolization of benign and malignant bone and soft tissue tumors of the extremities

T he use of selective arterial embolization for treating bone tumors was first described by Feldman et al. in 1975 (1). In order to reduce bleeding during surgery, it was initially performed preoperatively. Lately, it has been used for controlling pain due to bone metastasis and management of some tumors, which do not respond to classical treatment (2, 3). Embolization of primary or metastatic bone and soft tissue tumors has a broad range of indications, from curative treatment to palliation. The main indications for embolization are reducing the risk of bleeding during and after surgery of hypervascularized tumors, simplifying the manipulation of tumors, the palliation of pain, bleeding, fever, and hypercalcemia-like symptoms in inoperable tumors, preventing further dissemination of a tumor, and increasing the response to chemotherapy and radiotherapy. Embolization may be a therapeutic alternative to surgery in cases in which surgery is inappropriate or associated with high risk (2, 4, 5–8).