Preoperative Embolization for the Treatment of Cervical Castleman Disease

• DOI: 10.1097/scs.0b013e318251880f
• Publication Date: 2012-05-24T15:16:25Z
• Authors: Alberto Sanchez-R...; Pedro Infante-Cossio; Alejandro Gonzale...; Juan-Jose Borrero...
• Keywords: Adult; Castleman Disease; Contrast Media; Combined Modality Therapy; Embolization, Therapeutic; Magnetic Resonance Imaging; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Head and Neck Neoplasms; Humans; Female; Tomography, X-Ray Computed

Castleman disease (CD) is a rare benign lymphoproliferative disorder commonly described as a hypervascular mass that causes progressive lymph node enlargement. Head and neck involvement occurs only in 15% to 20% of cases. The recommended treatment in solitary CD is radical resection. Few reports have described the use of angiographic study and preoperative embolization to minimize the intraoperative risk of hemorrhage. We report a clinical case of a solitary large painless, slow-growing mass located in the neck of a 34-year-old woman. Contrast-enhanced computed tomographic and magnetic resonance imaging scan demonstrated a well-defined mass with internal calcifications and peripheral vessels located in the posterior cervical space, extending inferiorly to the supraclavicular space, which moderately enhanced after contrast administration. In the preoperative arteriography, a hypervascularized mass was identified, which mainly received an arterial supply from thyrocervical trunk. Successful embolization with polyvinyl alcohol microparticles was performed, resulting in a significant reduction of intraoperative bleeding, allowing a subsequently safe removal of the tumor. Histopathologic examination corresponded to hyaline vascular-type CD.