Embolization of Metastatic Undifferentiated Pleomorphic Sarcoma to the Stomach

Richard Grinstead, DO

Director of Interventional Radiology

Carolina Radiology Associates
McLeod Regional Medical Center

Patient presented with hypotension and decreased hemoglobin due to bleeding gastric mass
Patient diagnosed with metastatic undifferentiated pleomorphic sarcoma in March 2020
Oncology required embolization prior to initiating radiation therapy to control bleeding
Distal GDA was embolized with a LOBO-3 occluder
Vessel occlusion was achieved within 30 seconds
Patient did well post-operatively and required no further blood product after embolization

Figure 1: Coronal preoperative CT angiography for gastric embolization

Figure 2: DSA of GDA prior to gastric embolization

Figure 3: DSA of GDA post-embolization

Figure 4A: DSA of left gastric artery pre-embolization

Figure 4B: Angiogram with contrast tumor

Figure 5: Cone beam CT MIP 1

The LOBO-3 was chosen for embolization of the distal GDA because of the one-and-done nature of the device and its ease of deployment. The LOBO tracked well distally in the GDA. The device trackability is particularly notable as this case required the furthest tracking into the GDA in the physician’s embolization experience.

In addition, LOBO’s lack of metallic scatter artifact is less likely to obscure the stomach mass on future surveillance CT scans, which the patient will most likely need to undergo given the metastatic nature of her disease.