Preoperative endovascular embolization of orbital solitary fibrous tumor with 500-700 micron tris-acryl gelatin microspheres

Abstract

The reported experience with preoperative embolization of solid orbital tumors is scarce. Herein, we present a case of a large and hypervascular orbital solitary fibrous tumor (SFT) in which 500-700 mu m tris-acryl gelatin microspheres (TAGM) were used for preoperative embolization. A 41-year-old man presented with severe proptosis, palpable mass, restrictive myopathy, exposure keratopathy, and compressive optic neuropathy in the right orbit. Magnetic resonance imaging showed a 65x35x35 mm, diffusely contrast-enhanced tumor in the superior orbit, extending to the apex, and multiple intratumoral vascular flow voids. A diagnosis of SFT was made by incisional biopsy. Endovascular tumor embolization was performed with 500-700 mu m TAGM. Two days later, the tumor was entirely removed with minimal bleeding. No embolization-or surgery-related complications and tumor recurrence or metastasis developed during the 42-month postoperative follow-up.