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January 24, 1977

Selective Renal Artery EmbolizationTreatment for Metastatic Sarcoma With Hematuria

JAMA. 1977;237(4):363-364. doi:10.1001/jama.1977.03270310047007

IN A PATIENT with metastatic sarcoma to the kidney from a primary liposarcoma of the chest wall, the successful management of hematuria by use of embolization of the right renal artery can preclude the need for nephrectomy.

Report of a Case  A 62-year-old man with a known history of liposarcoma of the chest wall with metastases in the lungs (Fig 1) being treated with doxorubicin hydrochloride (Adriamycin) was admitted from the emergency room for hematuria and clot retention. The hemorrhage was severe, requiring the transfusion of four units of blood. An excretory urogram showed a delay in the function of the right kidney with a suggestion of a mass in the upper pole. The bladder showed multiple filling defects. Cystoscopy showed bleeding from the right ureteral orifice. Splaying of calyces and infundibula in the upper pole of the right kidney was demonstrated with a retrograde pyelogram.A clinical diagnosis of