Castleman disease: Report of a case and review of literature on role of preoperative embolization

INTRODUCTION: Castleman disease, which was first described by Dr. Castleman in 1954, is relatively rare and represents a spectrum of heterogeneous lymphoproliferative disorders with characteristic histological features on biopsy. It is classified based on body location and histology with variable clinical presentations. Its treatment depends on the subtype, and preoperative embolization for Castleman disease has rarely been discussed in the literature. PRESENTATION OF CASE: A 22-year old man presented to the ENT clinic with a four-week history of a mass on the left side of the neck, which was associated initially with headache, fever, and fatigue for 2 days. Contrast tomography and magnetic resonance imaging revealed a hypervascular mass located at levels two and three of the left side of the neck with feeding vessels from the external carotid artery. Preoperative embolization was planned; however, the neurointerventionist considered it a lymph node that did not need embolization. Surgical excision was performed with relatively increased operative time and bleeding. A biopsy confirmed a hyaline-vascular type Castleman disease. DISCUSSION: We reviewed the evidence-based management of CD. We reviewed the available literature on the role of preoperative embolization in management. CONCLUSION: Based on published articles and the hypervascular nature of the disease, we believe that preoperative embolization helps decrease morbidity.