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Case Reports
. 2016 Jul;77(3):e139-43.
doi: 10.1055/s-0036-1586210.

Direct Tumor Embolization of Sinonasal Unclassified Spindle Cell Sarcoma with Onyx

Ankit Kansal  1 , Prateek Srinet  1 , Richard Peter Manes  1
Affiliations
Case Reports

Direct Tumor Embolization of Sinonasal Unclassified Spindle Cell Sarcoma with Onyx

Ankit Kansal et al. J Neurol Surg Rep. 2016 Jul.

Abstract

Objectives: To evaluate the use of a new tumor embolization agent, Onyx (Covidien, Dublin, Ireland), for the use of intraoperative embolization of a sinonasal unclassified spindle cell sarcoma.

Methods: A 45-year-old female patient presented to the rhinology clinic with a nasal mass. A biopsy revealed a highly vascular mass consistent with a sinonasal unclassified spindle cell sarcoma. Secondary to its extensive vascularity, the patient underwent preoperative transarterial embolization (TAE) before definitive resection. Due to complex vascular anatomy including feeding vessels emanating from intracranial circulation, incomplete embolization was achieved. Subsequently, intraoperative embolization with Onyx at the time of resection was performed.

Results: Intraoperative Onyx use resulted in almost complete devascularization of the tumor with decreased risk of intracranial embolization.

Conclusions: Intraoperative embolization with Onyx after an incomplete TAE can be a safe and effective method of achieving near-total embolization of sinonasal tumors.

Keywords: Onyx; intraoperative embolization; sinonasal sarcoma.

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Figures

Fig. 1
Fig. 1
MRI coronal T1 postcontrast showing sinonasal sarcoma. MRI, magnetic resonance imaging.
Fig. 2
Fig. 2
CT sinus coronal section showing sinonasal sarcoma. CT, computed tomography.
Fig. 3
Fig. 3
Pretransarterial embolization showing blood supply from ophthalmic collaterals.
Fig. 4
Fig. 4
Posttransarterial embolization showing remaining blood supply.
Fig. 5
Fig. 5
Coronal view showing intra-arterial embolization.
Fig. 6
Fig. 6
Sagittal view showing intra-arterial embolization.
Fig. 7
Fig. 7
CT sinus coronal section 1 week postoperatively. CT, computed tomography.
See this image and copyright information in PMC

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