Preoperative embolization for the treatment of cervical Castleman disease

J Craniofac Surg. 2012 May;23(3):e257-9. doi: 10.1097/SCS.0b013e318251880f.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Castleman Disease / diagnosis*
  • Castleman Disease / pathology
  • Castleman Disease / therapy*
  • Combined Modality Therapy
  • Contrast Media
  • Embolization, Therapeutic*
  • Female
  • Head and Neck Neoplasms / diagnosis*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Magnetic Resonance Imaging
  • Tomography, X-Ray Computed

Substances

  • Contrast Media