A huge retroperitoneal Castleman's disease - rare entity

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Castleman disease is a rare lymphoproliferative disorder characterized by angiofollicular hyperplasia.
• It commonly affects lymph nodes in the mediastinum, neck, axilla, and pelvis, but can occur in extra-nodal sites.
• Castleman disease can mimic malignant tumors, posing diagnostic challenges.

Observation:

• A 56-year-old female incidentally discovered a retroperitoneal mass via contrast-enhanced CT scan.
• FDG-PET imaging revealed a well-defined, intensely FDG-avid lesion in the left iliac region with significant vascularity.
• Surgical intervention was performed for the retroperitoneal mass.

Findings:

• Pathological examination confirmed the diagnosis of hyaline vascular-type Castleman disease, a stroma-rich variant.
• The retroperitoneal mass was substantial in size, as indicated by the term "huge" in the case report.
• The imaging findings, particularly FDG avidity and vascularity, were crucial in the diagnostic workup.

Implications:

• This case underscores the importance of considering Castleman disease in the differential diagnosis of retroperitoneal masses, even in atypical locations.
• Accurate diagnosis through imaging and histopathology is critical for appropriate patient management.
• Further research into the diverse presentations of Castleman disease can improve early detection and treatment strategies.