EMBOLIZATION IN THE PALLIATION OF COMPLICATIONS OF INOPERABLE PRIMARYPANCREATIC NEOPLASMS

Primary pancreatic neoplasm typically presents at an advanced stage wh ere surgical management may not be feasible. These patients are often symptomatic due to biliary obstruction but problems may also include g astrointestinal bleeding and endocrinological complications. We descri be two cases illustrating the use of palliative embolization in the co ntrol of biochemical and haemorrhagic complications of primary pancrea tic neoplasm. In one case, massive gastrointestinal bleeding from an i noperable primary pancreatic carcinoma was controlled by two embolizat ion procedures to produce devascularization of the primary lesion. In a second case, life-threatening hypercalcaemia was thought to be due t o secretion of a parathormone-like material from an inoperable islet c ell tumour. There was no evidence of liver metastases and the pancreat ic mass was embolized, following which serum calcium was reduced to ne ar normal levels with considerable clinical improvement. We conclude t hat there is a role for embolization of inoperable primary pancreatic neoplasm in the palliation of biochemical or haemorrhagic complication s of these tumours.