Category: Laparoscopic/ Robotic: Bladder
Introduction & Objective :
Castleman Disease is a rare disease of the lymphnodes and related tissue and is also referred giant lymphnode hyperplasia and angiofollicular lymph node hyperplasia. It is not cancer but a lymphoproliferative disorder similar to lymphoma. Multicentric Castleman Disease is treated as such and has been reported to lead to lymphoma if not treated. Unicentric Castleman Disease may become locally invasive and is treated with resection.
The patient was 58-year-old male who underwent a CT Chest screening. He was incidentally found to have a 3.1cm retroperitoneal mass. He had a history of melanoma that was excised with negative margins.
The patient underwent a percutaneous CT guided biopsy which demonstrated Hyaline-Vascular Type Castleman Disease. He subsequently underwent staging CT scan to confirm the diagnosis of unicentric Castleman Disease following consultation with Medical Oncology. HHV-8 and HIV were negative. He was recommended to undergo surgical resection.
To our knowledge, this is the first report of Robotically Resected Castleman Disease.
Methods : We used robotic-assisted surgery to visualize, mobilize, precisely resect, and extract the mass from a difficult to access retroperitoneal region.
EBL: 100 cc
Dock Time: 123 minutes
Pathology: Hyaline-Vascular Type Castleman’s Disease 8 cm
Castleman Disease is amenable to robotic or laparoscopic approaches to resection. Care should be taken secondary to the desmoplastic reaction surrounding the tumor and the locally infiltrated effect of the lymphoproliferation. This should be resected as soon as reasonably possible to avoid disease progression.
Christopher Keel– Urologist, Fairhope Urology, Fairhope, Alabama
Christopher E. Keel, DO, FACS is a Urologic Surgeon from Fairhope, Alabama USA, who is Board Certified by the American Board of Urology. Dr. Keel is a native of Chattanooga and is a graduate of the University of Tennessee at Chattanooga. He subsequently received his medical degree from Nova Southeastern University in Fort Lauderdale, Florida. He then completed an internship in General Surgery at Tulane University Medical Center and the Spirit of Charity Trauma Center in New Orleans, Louisiana. He completed his robotic and urologic training at Tulane University Medical Center through the Department of Urology.
Dr. Keel has been recognized for his achievements in researching the impact of surgery on the kidney and for developing novel approaches for minimally invasive surgery. For his dedication to patient care and leadership, in 2013, he was recognized as the “Physician Of The Year” at the Spirit of Charity Trauma Center and Interim LSU Public Hospital.
Dr. Keel is an active member of the Southeastern Section of the American Urological Association, American Urological Association, Society of Robotic Surgeons, and the American College of Surgeons. He is an invited reviewer for several peer reviewed publications.