Induction R-CHOP therapy facilitates curative resection of initially unresectable hyaline-vascular unicentric Castleman disease: a case report

This is the first comprehensive report demonstrating that short-course R-CHOP chemoimmunotherapy safely and effectively serves as a "bridge-to-surgery" for initially unresectable hyaline-vascular unicentric Castleman disease (HV-UCD). The 8.3×5.5 cm mediastinal tumor, characterized by CD20+ B-cell hyperplasia and increased vascularity, encases the right pulmonary artery and bronchus with high risks of catastrophic hemorrhage and airway injury. Four 21-day R-CHOP cycles achieved >50% tumor shrinkage, established a clear tissue plane, facilitated safe R0 resection, and yielded 12-month disease-free survival without severe adverse events, offering novel evidence for high-risk HV-UCD management.