Key result
Transarterial embolisation successfully achieved haemostasis following a rapid 1L intraoperative haemorrhage during open biopsy of a neck mass later confirmed as Ewing's sarcoma.
Case Report (n=1)
Transarterial embolisation can play a key role in achieving haemostasis for major haemorrhage complicating open biopsy of neck masses.
Anticipate major bleeding during open biopsy of paraspinal lesions; Level 5 evidence leaves open embolization's routine role.
A 65-year-old man presented with a right supraclavicular neck mass and right arm pain. Magnetic resonance imaging revealed a 96mm lesion in the upper thoracic paraspinal region extending into the deep supraclavicular fossa. The presentation was consistent with a sarcoma or lymphoma but fine needle aspiration was inconclusive. During open biopsy of the lesion, the patient had a rapid intraoperative haemorrhage of 1l from the tumour. Haemostasis could only be achieved by transarterial embolisation of the feeding vessel and the biopsy result confirmed Ewing's sarcoma. Open biopsy is considered the gold standard in the diagnosis of certain tumour types; however, the morbidity from haemorrhage must be considered. This case highlights the key role that transarterial embolisation can play in achieving haemostasis in the neck.
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Walsh et al. (2017) conducted a case report in Neck mass / Ewing's sarcoma with intraoperative haemorrhage (n=1). Transarterial embolisation was evaluated on Haemostasis. Transarterial embolisation successfully achieved haemostasis following a rapid 1L intraoperative haemorrhage during open biopsy of a neck mass later confirmed as Ewing's sarcoma.
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