Transoral robotic surgery tongue base debulking in Castleman’s disease

Abstract

Dear Editor, Transoral robotic surgery has undergone improvements in recent years and increased diffusion can implicate changes in the surgical approach of many conditions involving Waldeyer’s ring structures, even the less common ones. Castleman’s disease is a rare lymphoproliferative disorder involving lymphatic structures with the possibility of unicentric or multicentric involvement. It usually arises as a solitary mass, commonly found in the mediastinum (60%), neck (14%), retroperitoneum (11%), or axilla (4%) 1. Its aetiology is unknown, but a role of viral infection is hypothesised (Herpesiviridae, HHV8) involving the B-cell pool and the lymphovascular compartment of lymph nodes 2. Histological classification differentiates hyaline vascular versus plasma cell disease according to the pattern of destruction of normal lymph node morphology, with the possibility of a mixed type including both 3. Surgical treatment is the main therapeutic option, mostly for the unicentric type 4. The neck is the second most frequent location, mainly in lymph nodes 1,3, but with the possibility of lymphoreticular structures involvement, such as Waldeyer’s ring. See full text