Preoperative embolization and lung-sparing robotic surgery in intrathoracic Castleman's disease: case report

Castleman's disease is a rare lymphoproliferative disorder that may present as unicentric or multicentric, with differing therapeutic implications. We report the case of a 23-year-old woman with unicentric Castleman's disease in the mediastinum. Following unsuccessful systemic therapy with corticosteroids and monoclonal antibodies, she underwent successful preoperative embolization using Embosphere® microspheres and subsequent robotic-assisted resection. This approach minimized blood loss (<100 mL) and facilitated safe dissection in a surgically challenging region. The patient had an uneventful postoperative course and was discharged on postoperative day seven. This case highlights the benefits of combining embolization with robotic surgery in managing hypervascular mediastinal lesions, offering a minimally invasive and safe alternative in selected patients.