title: Preoperative embolization for the treatment of cervical Castleman disease.
abstract: Castleman disease (CD) is a rare benign lymphoproliferative disorder commonly described as a hypervascular mass that causes progressive lymph node enlargement. Head and neck involvement occurs only in 15% to 20% of cases. The recommended treatment in solitary CD is radical resection. Few reports have described the use of angiographic study and preoperative embolization to minimize the intraoperative risk of hemorrhage. We report a clinical case of a solitary large painless, slow-growing mass located in the neck of a 34-year-old woman. Contrast-enhanced computed tomographic and magnetic resonance imaging scan demonstrated a well-defined mass with internal calcifications and peripheral vessels located in the posterior cervical space, extending inferiorly to the supraclavicular space, which moderately enhanced after contrast administration. In the preoperative arteriography, a hypervascularized mass was identified, which mainly received an arterial supply from thyrocervical trunk. Successful embolization with polyvinyl alcohol microparticles was performed, resulting in a significant reduction of intraoperative bleeding, allowing a subsequently safe removal of the tumor. Histopathologic examination corresponded to hyaline vascular-type CD.
authors.affiliation: Interventional Neuroradiology, Department of Radiology, Virgen del Rocio University Hospital, Seville, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sanchez-Ros-Sanchez
authors.forename: Pedro
authors.initials: P
authors.lastname: Infante-Cossio
authors.forename: Alejandro
authors.initials: A
authors.lastname: Gonzalez-Garcia
authors.forename: Juan-Jose
authors.initials: JJ
authors.lastname: Borrero-Martin
mesh_terms: D000328:Adult; D005871:Castleman Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media