Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202501672
Jornal Vascular Brasileiro
Relato de Caso

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

Embolização pré-operatória e cirurgia robótica com preservação pulmonar na doença de Castleman intratorácica: relato de caso

Felipe Furtado Leite; Ricardo Sales dos Santos; Priscila Mina Falsarella; Kauê Polizel Souza; Breno Boueri Affonso; Leonardo Guedes Moreira Valle; Mario Cláudio Ghefter; Felipe Nasser

http://dx.doi.org/10.1590/1677-5449.202501672 J Vasc Bras, vol.24, e20250167, 2025
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Abstract

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.

Keywords

Castleman disease, robotic surgical procedures, therapeutic embolization, mediastinum, minimally invasive surgery, case reports

Resumo

A doença de Castleman é uma doença linfoproliferativa rara que pode se apresentar como unicêntrica ou multicêntrica, com diferentes implicações terapêuticas. Relatamos o caso de uma mulher de 23 anos de idade com doença de Castleman unicêntrica no mediastino. Após terapia sistêmica com corticosteroides e anticorpos monoclonais sem sucesso, a paciente foi submetida a embolização pré-operatória bem-sucedida, com microesferas Embosphere® e subsequente ressecção assistida por robô. Essa abordagem minimizou a perda sanguínea (<100 mL) e facilitou a dissecção segura em uma região cirurgicamente desafiadora. A paciente teve um pós-operatório sem intercorrências e recebeu alta no sétimo dia de pós-operatório. Este caso destaca os benefícios da combinação de embolização com cirurgia robótica no manejo de lesões mediastinais hipervasculares, oferecendo uma alternativa minimamente invasiva e segura em pacientes selecionados.

Palavras-chave

doença de Castleman, cirurgia robótica, embolização terapêutica, mediastino, cirurgia minimamente invasiva, relato de caso

Referências

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Submetido em:
16/10/2025

Aceito em:
15/12/2025

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