Emergency embolization of a Wilms' tumor for life-threatening hemorrhage prior to nephrectomy

•2 year old girl presented with a life threatening hemorrhage from a Wilms' tumor.•Patient received a renal artery embolization prior to nephrectomy.•Embolization allowed patient to be stabilized for definitive surgical treatment.•Embolization impaired frozen section diagnosis, but did not affect tumor grading.

A 2 year 9 month-old girl presented with active hemorrhage from a Wilms' tumor. The hemorrhage was controlled with embolization of the left renal artery and a left nephrectomy was subsequently performed. Embolization to control active bleeding in trauma scenarios and as a preoperative intervention to minimize blood loss has been extensively reported in the pediatric population. There are very few case reports of embolization of an actively bleeding tumor.