[Surgical Treatment to Castleman's Disease after Embolization of Feeding Vessels]

Area of Science:

• Thoracic Surgery
• Vascular Interventions
• Oncology

Background:

• Castleman's disease is a rare lymphoproliferative disorder.
• Mediastinal masses require accurate diagnosis and treatment planning.
• Vascularity of mediastinal tumors can pose significant surgical challenges.

Observation:

• A 4.4 cm right upper mediastinal mass was identified on chest CT.
• The mass exhibited significant vascularity, suggesting potential for severe intraoperative bleeding.
• Castleman's disease was suspected based on imaging findings.

Findings:

• Preoperative embolization of feeding vessels successfully reduced tumor vascularity.
• Surgical tumor extirpation via thoracotomy was performed with minimal blood loss (50 ml).
• Pathological diagnosis confirmed hyaline vascular type Castleman's disease.

Implications:

• Preoperative embolization is an effective strategy for managing highly vascular mediastinal tumors.
• Minimally invasive techniques can be employed for complex thoracic surgeries.
• This case highlights the importance of multidisciplinary approaches in managing rare thoracic conditions.