2015 Volume 29 Issue 1 Pages 95-100
The patient was a 23-year-old man. An abnormal chest shadow was detected in the mediastinum on radiograph. Contrast-enhanced chest computed tomography showed a large mass of approximately 8 cm in diameter in the middle mediastinum. The hypervascular mass compressed the bilateral main pulmonary arteries, pulmonary veins, and bilateral main bronchi. Transbronchial and surgical biopsy of the tumor revealed no findings of malignancy. Therefore, the patient underwent surgery for a definite diagnosis and treatment. Preoperative embolization of the bronchial artery was performed on the day before surgery because bleeding from the tumor during the initial surgical biopsy was difficult to control. We performed the operation through a left thoracotomy. Firstly, we dissected severe adhesions between the tumor and left main pulmonary artery and main bronchus. Thereafter, we performed complete resection of the tumor by dissecting the remaining adhesions between the tumor and surrounding organs. Preoperative embolization resulted in reduction of the amount of bleeding during surgery. The final histological diagnosis was Castleman disease (hyaline vascular type).
