Thoracoscopic approach to giant lymph node hyperplasia (Castleman's disease)

Area of Science:

• Thoracic Surgery
• Oncology
• Pathology

Background:

• Giant lymph node hyperplasia, or Castleman's disease, is a rare lymphoproliferative disorder.
• Mediastinal involvement presents diagnostic and surgical challenges.
• Accurate preoperative diagnosis is crucial for appropriate management.

Observation:

• A patient presented with a mediastinal mass initially suspected to be substernal goiter.
• Cervical exploration revealed the mass was not continuous with the thyroid gland.
• A lateral thoracoscopic approach was utilized for mass identification and removal.

Findings:

• Histopathology confirmed the diagnosis of Castleman's disease, mixed type.
• The thoracoscopic approach facilitated easy identification and complete resection of the mediastinal mass.
• The patient experienced an uneventful recovery and was discharged on postoperative day five.

Implications:

• Thoracoscopic surgery may be the optimal minimally invasive approach for mediastinal Castleman's disease.
• This case highlights the importance of considering Castleman's disease in mediastinal mass differentials.
• Endoscopic techniques offer potential advantages in managing rare mediastinal pathologies.