Combinatorial treatment for unresectable unicentric Castleman disease

Eur J Haematol. 2021 Oct;107(4):484-488. doi: 10.1111/ejh.13685. Epub 2021 Jul 18.

Abstract

Unresectable, symptomatic unicentric Castleman disease (UCD) can represent a formidable therapeutic challenge. UCD masses are often highly vascularized offering the opportunity for therapeutic embolization. Herein, we report on 6 patients in which therapeutic embolization was combined with other medical interventions including surgery (n = 3), rituximab (n = 6), cryoablation (n = 2), and chemotherapy (n = 3). Five patients had significant tumor volume reductions (median: 83.2%; range: 76.7-100). All five responding patients had resolution of symptomatology. There were no serious complications in the patients who received embolization and proceeded to surgery. In conclusion, effective disease and symptom control can be obtained in patients with symptomatic, unresectable UCD by combining different therapeutic interventions.

Keywords: embolization; unicentric Castleman disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Axilla
  • Castleman Disease / diagnostic imaging
  • Castleman Disease / pathology
  • Castleman Disease / surgery
  • Castleman Disease / therapy*
  • Combined Modality Therapy / methods*
  • Cryosurgery / methods*
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Male
  • Mediastinum
  • Middle Aged
  • Pelvis
  • Prednisone / therapeutic use
  • Rituximab / therapeutic use
  • Treatment Outcome
  • Vincristine / therapeutic use

Substances

  • R-CHOP protocol
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone