{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T15:04:14Z","timestamp":1789830254009,"version":"4.0.1"},"reference-count":8,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Renal artery embolization has been used in a palliative fashion for symptomatic relief of hematuria or flank pain in unresectable renal cell carcinoma in adults. There is limited data on the use of embolization for actively bleeding and unresectable tumors in the oncological pediatric population.<\/jats:p>\n <\/jats:sec>\n \n Case Description<\/jats:title>\n A previously healthy 5-year-old boy with no significant past medical or surgical history presented to the clinic with gradually worsening abdominal distension associated with occasional abdominal pain, gross hematuria, and lethargy for four months. Diagnostic investigations showed an 18-cm left-sided metastatic (pulmonary) renal tumor (Wilms), which was deemed unresectable on imaging. Treatment was planned according to the SIOP-RTSG protocol. However, he became hemodynamically and vitally unstable with acute, sudden distension of the abdomen on the left side after the first cycle of chemotherapy. Imaging showed active bleeding from an inferior branch of the left renal artery. Selective angioembolization was done, and chemotherapy was reinitiated with a patent left main renal artery. Following the fourth cycle of chemotherapy, he developed hemodynamic instability and abdominal pain; imaging revealed the resolution of pulmonary nodules and bleeding from the left renal artery (main); this was again embolized, and the patient was stabilized. The patient was operated on after optimization, and a complete resection of the mass was done with negative margins. On six months follow-up, he is well.<\/jats:p>\n <\/jats:sec>\n \n Practical Implications<\/jats:title>\n To the best of our knowledge, this is the first case where angioembolization has been done in conjunction with neoadjuvant chemotherapy to downsize a Wilms tumor to achieve favorable outcomes. Continued research efforts are necessary to optimize strategies and improve the prognosis for pediatric patients, and this case is one of the prime examples.<\/jats:p>\n <\/jats:sec>","DOI":"10.37029\/jcas.v10i1.603","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T18:58:34Z","timestamp":1706036314000},"page":"1-5","source":"Crossref","is-referenced-by-count":1,"title":["Emergency Angioembolization for Life-Threatening Hemorrhage in Wilms Tumor"],"prefix":"10.2478","volume":"10","author":[{"given":"Areej","family":"Salim","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Punjab , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajid","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Punjab , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ali","family":"Sheikh","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Punjab , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tariq","family":"Latif","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Punjab , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Islah Ud","family":"Din","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre , Lahore , Punjab , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"2026091914280681034_j_jcas.v10i1.603_ref_001","doi-asserted-by":"crossref","unstructured":"Sauk S, Zuckerman DA. Renal artery embolization. Semin Intervent Radiol 2011;28:396-406.","DOI":"10.1055\/s-0031-1296082"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_002","doi-asserted-by":"crossref","unstructured":"Sharma R, Kitchen BJ, Mody R, Chamdin A, Bruch S, Jasty R. A report of renal artery embolization for hematuria facilitating neoadjuvant chemotherapy in an unresectable malignant renal rhabdoid tumor. Pediatr Surg Int 2013;29:533-5.","DOI":"10.1007\/s00383-013-3260-5"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_003","doi-asserted-by":"crossref","unstructured":"Smith NP, Jesudason EC, McDowell HP, Rowlands P, Ashworth M, Losty PD. Emergent embolisation to control severe haematuria in Wilms\u2019 tumour. Pediatr Surg Int 2005;21:313-5.","DOI":"10.1007\/s00383-005-1402-0"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_004","doi-asserted-by":"crossref","unstructured":"Chitnis M, Chowdhary SK, Lazarus C. Preoperative angioembolisation for life-threatening haemorrhage from Wilms\u2019 tumour: A case report. Pediatr Surg Int 2004;20:290-1.","DOI":"10.1007\/s00383-003-1128-9"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_005","doi-asserted-by":"crossref","unstructured":"Van den Heuvel-Eibrink MM, Hol JA, Pritchard-Jones K, van Tinteren H, Furtw\u00e4ngler R, Verschuur AC, et al. Rationale for the treatment of Wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol 2017;14:743-52.","DOI":"10.1038\/nrurol.2017.163"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_006","doi-asserted-by":"crossref","unstructured":"Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist 2004;9:561-70.","DOI":"10.1634\/theoncologist.9-5-561"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_007","doi-asserted-by":"crossref","unstructured":"Harrison MR, de Lorimier AA, Boswell WO. Preoperative angiographic embolization for large hemorrhagic Wilms\u2019 tumor. J Pediatr Surg 1978;13:757-8.","DOI":"10.1016\/S0022-3468(78)80128-6"},{"key":"2026091914280681034_j_jcas.v10i1.603_ref_008","doi-asserted-by":"crossref","unstructured":"Ruff S, Bittman M, Lobko I, Williamson A, Dolgin S. Emergency embolization of a Wilms\u2019 tumor for life-threatening hemorrhage prior to nephrectomy. J Pediatr Surg Case Rep 2014;2:280-3.","DOI":"10.1016\/j.epsc.2014.05.013"}],"container-title":["Journal of Cancer and Allied Specialties"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sfu.ca\/jcas\/index.php\/jcas\/article\/download\/603\/511","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/reference-global.com\/pdf\/10.37029\/jcas.v10i1.603","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:28:13Z","timestamp":1789828093000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.37029\/jcas.v10i1.603"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,23]]},"published-print":{"date-parts":[[2024,1,1]]}},"alternative-id":["10.37029\/jcas.v10i1.603"],"URL":"https:\/\/doi.org\/10.37029\/jcas.v10i1.603","relation":{},"ISSN":["2411-989X"],"issn-type":[{"value":"2411-989X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,1]]}}}