84-year-old female patient with a history of hypertension, hyperthyroidism, type II diabetes mellitus and anxiety syndrome. She was referred to the Urology Outpatient Department from the Emergency Department for a picture of monosymptomatic frank haematuria of several weeks' evolution with no other associated symptoms or alteration in general condition.
Physical examination revealed the presence of a palpable mass in the right lumbar fossa. The abdomen was soft and depressible.
The requested ultrasound study showed a large heterogeneous solid mass in the lower pole of the right kidney, the contralateral kidney being normal. The bladder showed internal echoes compatible with clots. The cystoscopic study was unremarkable.
Abdomino-pelvic CT scan, chest X-ray, blood biochemistry and haemogram were also performed.
The CT scan showed a large right tumour mass measuring 9x10 cm, heterogeneous and with hypodense areas (areas of necrosis) with distortion of the renal parenchyma and its contour, located in the lower pole and with attenuation values lower than those of the healthy parenchyma. The renal vein was thrombosed and there were retroperitoneal locoregional adenopathies.

Laboratory tests showed the presence of iron deficiency anaemia, increased ESR and normocalcaemia.
Radical surgery was proposed, which the patient and her family rejected, and selective embolisation was accepted as an alternative.
By puncture of the right common femoral artery, arteriography of the abdominal aorta was performed and subsequently the right renal artery was selectively catheterised with a 5 Fr Cobra 2 visceral angiographic catheter (Angiodinamics®). The artery supplying the tumour is then embolised with 355-500 micron polyvinyl alcohol (PVA) particles (Contour®, Boston Scientific), totally occluding the flow of the artery without immediate complications.

After 24 hours of hospitalisation, given the good evolution of the patient, it was decided to discharge her from the hospital pending further check-ups.
Two weeks after the onset of anticoagulation, the patient consulted for a headache and a brain CT scan was performed, which showed no findings of pathological significance. After 28 months of follow-up, there have been no further episodes of haematuria and the only notable symptomatology is insomnia and musculoskeletal pain, both controlled with symptomatic treatment. Blood pressure values have not been modified, maintaining acceptable figures with IECAS and calcium antagonists.
