Palliative embolization arteries or veins for a recurrent pelvic chondrosarcoma

Chondrosarcoma is a malignant bone tumor characterized by the formation of cartilage structures of varying degrees of ma-turity. They account for approximately 20 % of malignant skele-tal tumors. Chondrosarcoma most often affects the pelvis (iliac bone), the proximal femur and humerus, ribs. The chondrosar-coma of the pelvis has a low response to chemo- and radiation therapy, so they are usually resected by standard hemipelvec-tomy. New surgical reconstructive techniques allow surgeons to perform major reconstructions, thereby improving patients' quality of life. Clinical case: male, 64 years old, with complains of the left thigh pain for 6 months. The patient was made a com-prehensive examination — standard X-rays, MRI and CT scan of the pelvis, biopsy of the pathological formation. Diagnosis: chondrosarcoma II clinical group, stage IIB. Primary sur-gery — wide-field excision and reconstruction with a massive bone allograft was performed and bipolar hip replacement. Two major local recurrences were detected in 3 years. Due to inef-ficiency of chemo- and radiation therapy, refusal of the patient from amputation, high degree of tumor vascularization, arterial embolization was applied. A selective study of both the medial and lateral femoral arteries was performed using a uroangio-graphic contrast medium. The achievement of complete devas-cularization of the greatest lesion was confirmed angiographi-cally. After 20 days due to partial revascularization, re-emboli-zation of the lateral circular femoral artery was made. The final embolization of all arterial branches that fed the tumor was performed after 3 months with acrylic (n-butyl 2-cyanoacrylate) glue for larger-sized vessels and microparticles of polyvinyl al-cohol (150– 250 μm) for the smallest branches. Conclusion: em-bolization can be effectively used as a palliative treatment for highly vascularized pelvic chondrosarcoma. Key words: chond-rosarcoma, pelvis, embolization, palliative, polyvinyl alcohol microparticles.