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Retroperitoneal Castleman's disease.

A Ari Hakimi1, Izak Faiena, Ronald N Kaleya

  • 1Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

Urology
|February 9, 2010
PubMed
Summary

A large retroperitoneal mass initially suspected as liposarcoma in a colon cancer patient was surgically removed. Final pathology revealed it was Castleman

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Area of Science:

  • Oncology
  • Surgical Pathology
  • Diagnostic Imaging

Background:

  • A 56-year-old postmenopausal woman with a history of colon cancer presented with abdominal pain, early satiety, and weight loss.
  • Previous treatment included a left hemicolectomy for colon cancer.

Observation:

  • A large, enhancing, fat-containing retroperitoneal mass was identified on CT scan, displacing the left kidney and encasing the renal hilum.
  • The mass was initially suspected to be a retroperitoneal liposarcoma.

Findings:

  • The patient underwent wide excision of the mass, radical nephrectomy, and lymph node dissection via a thoracoabdominal approach.
  • Final pathology confirmed the mass was a large lymphatic malformation, consistent with Castleman's disease, not liposarcoma.

Implications:

  • This case highlights the importance of comprehensive histopathological examination for accurate diagnosis of retroperitoneal masses.
  • Castleman's disease can present as a large retroperitoneal mass, mimicking other malignancies and requiring surgical intervention.
  • Multidisciplinary surgical approaches may be necessary for complete resection of complex retroperitoneal lesions.

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