Open Access Maced J Med Sci electronic publication ahead of print, published on August 19, 2018 as https://doi.org/10.3889/oamjms.2018.282 _______________________________________________________________________________________________________________________________ Open Access Maced J Med Sci. 1 ID Design Press, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. https://doi.org/10.3889/oamjms.2018.282 eISSN: 1857-9655 Case Report Renal Arteries Embolization in Unresectable Clear Cell Renal Carcinoma: First Time Experience at Haji Adam Malik Hospital Noor Riza Perdana 1* , Elvita Rahmi Daulay 2 , Fauriski Febrian Prapiska 3 1 Department of Urology, Cipto Mangunkusumo National Hospital, University of Indonesia, Medan, Indonesia; 2 Department of Radiology, Haji Adam Malik Hospital, University of Sumatera Utara, Medan, Indonesia; 3 Urology Division, Department of Surgery, Haji Adam Malik Hospital, University of Sumatera Utara, Medan, Indonesia Citation: Perdana NR, Dulay ER, Febrian Prapiska F. Renal Arteries Embolization in Unresectable Clear Cell Renal Carcinoma: First Time Experience at Haji Adam Malik Hospital. Open Access Maced J Med Sci. https://doi.org/10.3889/oamjms.2018.282 Keywords: renal arterial embolisation; renal tumour; case report; Indonesia *Correspondence: Noor Riza Perdana. General Hospital Haji Adam Malik, Sumatera Utara, Indonesia. E-mail: rizaperdana13@gmail.com Received: 27-Apr-2018; Revised: 15-Jun-2018; Accepted: 20-Jun-2018; Online first: 19-Aug-2018 Copyright: © 2018 Noor Riza Perdana, Elvita Rahmi Dulay, Fauriski Febrian Prapiska. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) Funding: This research did not receive any financial support Competing Interests: The authors have declared that no competing interests exist Abstract OBJECTIVE: To report a case of renal arterial embolisation (RAE) in unresectable renal tumour before nephrectomy. CASE REPORT: On presentation, the clinical features of this patient, including medical history, signs and symptoms, imaging examinations were recorded. After diagnosis and initial treatment, the result and histopathological examination were performed and discussed. We performed RAE in the unresectable renal tumour in the 28-year-old male that was complaining a palpable pain right flank mass and intermittent hematuria that had been observed five months earlier. A month after RAE, the tumour shrinks and become resectable. The parameter used was tumour volume, propulsion and component, with subjective value VAS, hematuria symptom and Quality Of Life Score EORTC-QLQ C30. The next step we performed nephrectomy with histopathology results in Clear Cell Renal Carcinoma (CCRC). CONCLUSION: RAE is an effective therapeutic and adjuvant tool because it facilitates the dissection of unresectable large renal tumours and tumours with extensive involvement around the renal hilum; it leading to lower overall morbidity. However, the lack of randomised prospective studies is the primary reason that RAE is not used often before surgery. Introduction Renal cell carcinoma (RCC) constitutes approximately 90–95% of all kidney neoplasms, and 25–30% of all patients had metastatic disease upon its diagnosis. The incidence rates are high in the Czech Republic, and low in much of Africa and South-east Asia country [1]. In Indonesia, renal cell carcinoma was ranked 18 th in both sexes for the overall incidence. It occurs in 1.4-1.8 cases per 100.000 populations [2]. Renal arterial embolisation (RAE) has been proven safe and effective in managing renal cancer for several decades of experience. This procedure was first performed in 1973 by Almgard [3]. Since then, the procedure has developed due to advances in technology and instrumentation. The main indication of RAE is preoperative infarction of renal cancer before nephrectomy. It can also be done as palliation therapy for unresectable renal cancer, symptomatic hematuria, and treatment of angiomyolipomas (AMLs), treatment for vascular malformations, correcting of complications following renal transplantation and treatment for patients who are poor for surgical candidates [4]. In our country, systemic therapy for renal cancer has not been covered by the national health insurance. Therefore, RAE can be a promising treatment option for renal cancer patients. The long- term outcome of RAE, however, remains unknown. In this case report, we described a patient with RCC who