Castleman's disease: unusual case of inflammatory spinal dorsal epidural mass: case report

Castleman's disease (giant lymph node hyperplasia) is a rare, heterogeneous, lymphoproliferative disorder of unknown cause and pathogenesis. Most cases occur as mediastinal masses, although extrathoracic involvement, including nodal and extranodal locations, has been reported. The localized variants (solitary lesions) respond well to surgical excision.

We report the case of a 34-year-old man with headache, intermittent febrile sense, progressive weakness of the legs, and urinary incontinence. Magnetic resonance imaging disclosed an enhancing dorsal extradural mass with impingement on the spinal cord at the T2-T3 level. Other abnormal laboratory findings were increased erythrocyte sedimentation rate and mild leukocytosis.

The mass lesion was removed; the histopathological findings included diffuse lymphoid cell infiltration and vascular proliferation, which are compatible with Castleman's disease.

Although the dorsal epidural site of this case is very unusual, Castleman's disease was considered the most appropriate diagnosis on the basis of the associated systemic findings. This patient with dorsal epidural Castleman's disease may be the first reported case in the literature.