Moo-Chablé P

Language: Spanish
References: 6
Page: 159-161
PDF size: 205.89 Kb.

ABSTRACT

Introduction: Castleman’s disease is rare, its etiology and prevalence are unknown, it is estimated to be less than 1/100,000; causes an angiofollicular lymphoid hyperplasia and there are two forms: localized or unicentric (more frequent) and multicentric; surgical resection being the standard of treatment in Unicentric Castleman’s Disease (ECU); however, when it is unresectable or with incomplete resection, adjuvant radiotherapy is an option to achieve local control. Case report: Male, 27 years old, previously healthy, started in June 2015 with a navel tumor, not painful, with progressive growth up to 7 cm. The diagnostic CT reported pelvic tumor of 10.4 cm dependent on left psoas muscle; the biopsy reported «Castlemanoides changes», performing incomplete resection of the tumor (03/11/2016) because it was attached to inferior vena cava and left common iliac vein; pathology confirmed «Castleman’s disease», variant hyalinovascular, CD20 +. He started adjuvant radiotherapy, with VMAT technique (volumetric Arcotherapy), 40 Gy dose in 20 fractions, which ended 03/03/17. Results: PTV coverage of 99% was achieved; average dose to rectum, bladder and bulb of 8Gy, 9.25Gy and 0.53Gy respectively. At the end of the treatment, the patient presented radioepitelitis RTOG 1, which resolved at one month; no acute bladder or rectal toxicity. One year follow-up without disease recurrence. Conclusions: Adjuvant radiotherapy with VMAT technique is an appropriate option for the ECU with incomplete resection, making it possible to deposit high doses of radiation with minimal complications and with a good control rate.

REFERENCES

1. Chan KL et al. Update and new approaches in the treatment of Castleman disease. J Blood Med. 2016; 7: 145-158.

2. Matthiensen C et al. Intensity modulated radiation therapy (IMRT) for the treatment of unicentric Castlemans disease: a case report and review of the use of radiotherapy in the literature. Radiol Oncol. 2012; 46 (3): 265-270.

3. Karaca F et al. Radiotherapy and Castleman’s disease. Turk J Hematol. 2014; 31: 197-198.

4. Bracale U et al. Laparoscopic treatment of abdominal unicentric castleman’s disease: a case report and literature review. BMC Surgery. 2017; 17: 38.

5. Uysal B, Demiral S, Gamsiz H, Dincoglan F, Sager O, Beyzadeoglu M. Castleman’s disease and radiotherapy: a single center experience. J Can Res Ther. 2015; 11 (1): 170-174.

6. Ozkan H, Tolunay S, Gozu O, Ozer ZG. Giant lymphoid hamartoma of mediastinum (Castleman’s disease). Thorac Cardiovasc Surg. 1990; 38: 321-323.