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[Castleman disease].

J Sánchez de Toledo Sancho1, J Fàbrega Sabaté, C Marhuenda Irastorza

  • 1Servicio de Oncología Pediátrica, Hospital Vall d'Hebron, Barcelona, España. joansdts@comb.es

Anales De Pediatria (Barcelona, Spain : 2003)
|July 2, 2005
PubMed
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Castleman disease, a rare lymphoproliferative disorder, can present as localized mediastinal masses in children. Preoperative embolization effectively manages these vascular tumors before surgical resection.

Area of Science:

  • Oncology
  • Pediatric Hematology
  • Vascular Surgery

Background:

  • Castleman disease (angiofollicular hyperplasia) is a rare lymphoproliferative disorder of unknown etiology, possibly linked to viral infections.
  • It primarily affects young adults but is exceptionally rare in children, often presenting as localized, highly vascular mediastinal masses.
  • Classified into localized and disseminated forms with hyaline-vascular and plasma cell histologic variants.

Observation:

  • Localized Castleman disease in pediatric patients typically manifests as asymptomatic, highly vascular mediastinal masses.
  • Surgical resection is curative but carries a significant risk of intraoperative blood loss.
  • Preoperative arteriography with embolization has emerged as a valuable tool for managing these vascular tumors.

Findings:

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  • A 12-year-old girl with localized Castleman disease presented with a mediastinal mass.
  • The patient underwent successful preoperative embolization to reduce tumor vascularity.
  • Curative surgical resection was performed following embolization, with satisfactory outcomes.

Implications:

  • Preoperative embolization is a safe and effective strategy for managing pediatric localized Castleman disease.
  • This approach can mitigate the risks associated with surgical resection of highly vascular mediastinal masses.
  • Further research into the etiology and optimal management of Castleman disease in children is warranted.