Imaging Characteristics and Postoperative Outcomes of Head and Neck Unicentric Castleman Disease: A 20-Year...

PurposeHead and neck unicentric Castleman disease (HN-UCD) often lacks specific clinical and laboratory markers, leading to frequent preoperative misdiagnoses. While surgical resection typically offers a favorable prognosis, the management of atypical postoperative outcomes, such as new regional lymphadenopathy or persistent systemic symptoms, remains poorly defined. This study aimed to identify the characteristic imaging features of HN-UCD and explore effective management strategies for these atypical postoperative scenarios.MethodsA retrospective analysis was conducted on 24 patients diagnosed with HN-UCD at the Peking Union Medical College Hospital over the past 20 years. The preoperative imaging characteristics and postoperative clinical outcomes were systematically evaluated.ResultsImaging confirmed significant hypervascularity as a hallmark of HN-UCD: 94.4% (17/18) of lesions exhibited abundant and disordered blood flow signals on ultrasound, and 71.4% (10/14) of lesions presented with prominent feeding vessels on CT. Postoperatively, 87.5% (21/24) of the patients achieved complete remission within the surgical field. For the two patients exhibiting atypical outcomes (new regional lymphadenopathy and persistent fever), a strategy of rigorous follow-up was adopted after multidisciplinary exclusion of malignancy and infection; both patients remained clinically stable.ConclusionProminent feeding vessels and marked hypervascularity are characteristic preoperative imaging markers for HN-UCD. For patients with atypical postoperative outcomes, a management protocol based on multidisciplinary evaluation and close clinical observation is recommended.