The Role of Embolization in the Management of Musculoskeletal Tumors

Musculoskeletal tumors encompass a heterogeneous group of neoplasms that, owing to their location and aggressive nature, present significant therapeutic challenges. Within this context, embolization—a minimally invasive technique aimed at selectively occluding tumor-supplying blood vessels—is emerging as a promising complementary or, in certain instances, primary approach. Its potential to reduce tumor volume, control pain, and facilitate surgical intervention renders it an area of increasing clinical interest. This article explores the current role of embolization in treating diverse musculoskeletal tumors, analyzing available scientific evidence, clinical indications, procedural techniques, and potential complications. Available comparative evidence is most developed for preoperative embolization of hypervascular spinal tumors and metastatic lesions. Some systematic reviews and meta-analyses suggest a reduction in intraoperative blood loss, facilitation of surgical resection and improved pain palliation. Evidence concerning extra-spinal tumors, local tumor control, recurrence prevention, and selected benign lesions is more limited and is derived predominantly from small retrospective series. While complications are generally infrequent, they necessitate meticulous superselective catheterization and multidisciplinary planning to mitigate risks such as non-target embolization. Transarterial embolization has a selective, indication-dependent role in the multidisciplinary management of musculoskeletal tumors, particularly for preoperative devascularization of selected hypervascular lesions, promising improved patient outcomes.