title: Preoperative adrenal artery embolization followed by surgical excision of giant hypervascular adrenal masses: report of three cases.
abstract: BACKGROUND
  Transcatheter arterial embolization (TAE) is an effective minimally invasive adjunct to surgery for the management and/or palliation of adrenal tumors.
  
  
  METHODS
  In this case study, we reported three patients who underwent preoperative TAE before adrenalectomy for large hypervascular adrenal tumors. All patients underwent preoperative embolization 24 h before the operation and were then followed up at the intensive care unit surgery.
  
  
  RESULTS
  The largest diameter of the adrenal lesions ranged between 8 and 17 cm. Hypertensive attack occurred in one patient with pheochromocytoma during embolization. No other complications associated with the procedure was noted. The adrenal tumors were totally excised in all patients. The major intraoperative findings associated with preoperative embolization were marked reduction in hypervascularity and the decrease in the size of collateral vessels. No major hemorrhage necessitating blood transfusion were noted during surgery.
  
  
  CONCLUSIONS
  Preoperative embolization of large hypervascular adrenal masses could reduce perioperative blood loss by reducing tumor vascularity.
authors.affiliation: a Istanbul Faculty of Medicine, General Surgery Department , Istanbul University , Istanbul , Turkey.
authors.forename: Ismail Cem
authors.identifier: http://orcid.org/0000-0001-6907-978X
authors.initials: IC
authors.lastname: Sormaz
authors.affiliation: a Istanbul Faculty of Medicine, General Surgery Department , Istanbul University , Istanbul , Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Tunca
authors.affiliation: b Istanbul Faculty of Medicine, Radiology Department , Istanbul University , Istanbul , Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Poyanlı
authors.affiliation: a Istanbul Faculty of Medicine, General Surgery Department , Istanbul University , Istanbul , Turkey.
authors.forename: Yasemin Giles
authors.initials: YG
authors.lastname: Şenyürek
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D015901:Angiography, Digital Subtraction; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000098:blood supply / Q000175:diagnosis / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods*; D055815:Young Adult
keywords: PEComa; Preoperative embolization; adrenal mass; adrenocortical cancer; von Hippel-Lindau syndrome