1
|
Nakata K, Iwahashi N, Matsukawa H, Noguchi T, Yahata T, Ota N, Mabuchi Y, Ino K. Laparoscopically resected Castleman's disease in the pelvic retroperitoneum: A case report. Mol Clin Oncol 2019; 12:169-173. [PMID: 31929889 PMCID: PMC6951224 DOI: 10.3892/mco.2019.1963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 11/27/2019] [Indexed: 01/26/2023] Open
Abstract
Castleman's disease is a rare benign disorder of unknown etiology characterized by proliferation of lymphoid tissues. Castleman's disease arising from pelvic retroperitoneum is clinically rare. The present case report describes a rare case of laparoscopically resected Castleman's disease in the pelvic retroperitoneum associated with benign ovarian cyst. A 47-year-old woman, gravida 5, para 3, was referred to to the Department of Obstetrics and Gynecology of Wakayama Medical University with a suspected pelvic tumor. Magnetic resonance imaging revealed that the solid tumor was localized in the retroperitoneal space at the right side of the pelvis. The patient underwent laparoscopic surgery for the resection of the pelvic retroperitoneal tumor, with complete tumor resection. Postoperative pathological examination established the diagnosis of Castleman's disease. The postoperative course was uneventful, with no evidence of local recurrence or systemic disease 6 months after diagnosis.
Collapse
Affiliation(s)
- Kumiko Nakata
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Naoyuki Iwahashi
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Hitomi Matsukawa
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Tomoko Noguchi
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Tamaki Yahata
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Nami Ota
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Yasushi Mabuchi
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Kazuhiko Ino
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| |
Collapse
|
2
|
Retroperitoneal unicentric Castleman's disease: A case report. Int J Surg Case Rep 2017; 31:54-57. [PMID: 28107758 PMCID: PMC5247283 DOI: 10.1016/j.ijscr.2016.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 12/28/2016] [Accepted: 12/29/2016] [Indexed: 12/11/2022] Open
Abstract
Retroperitoneal Castleman’s disease in the peripancreatic region is a rare entity. Preoperative diagnosis is most often difficult and mimics malignant disease. Surgical en bloc excision is the most commonly performed treatment due to diagnostic dilemma. Preoperative biopsy in cases with strong clinical suspicion can avoid radical surgery.
Introduction Castleman’s disease (CD) is an angio-follicular lymph node hyperplasia presenting as a localized or a systemic disease masquerading malignancy. The most common sites of CD are mediastinum, neck, axilla and pelvis. Unicentric CD in the peripancreatic region is very rare. Presentation of case We report a case of the 34-year-old lady presenting with epigastric pain for 3 months. Abdominal imaging revealed a retroperitoneal mass arising from the pancreas suspected to be neuroendocrine tumor. Tumor markers were not elevated. Complete surgical excision was performed and patient had uneventful recovery. Pathologic findings demonstrated localized hyaline-vascular type of Castleman’s disease. Discussion CD is a very rare cause for development of retroperitoneal mass. It is more frequent in young adults without predilection of sex. It can occur anywhere along the lymphoid chain. Abdominal and retroperitoneal locations usually present with symptoms due to the mass effect on adjacent organs. CD appears as a homogeneously hypoechoic mass on ultrasound and non-specific enhancing homogeneous mass with micro calcifications on computed tomography. Histologically, the hyaline vascular type demonstrates a follicular and inter-follicular capillary proliferation with peri-vascular hyalinization, with expansion of the mantle zones by a mixed inflammatory infiltrate of numerous small lymphocytes and plasma cells. The standard therapy of localized form is en bloc surgical excision as performed in our case. Conclusion Unicentric CD in the peripancreatic region is difficult to differentiate from pancreatic neoplasm preoperatively. However, preoperative biopsy in cases of high clinical suspicion can help in avoiding extensive surgery for this benign disease.
Collapse
|
3
|
Ooi CC, Cheah FK, Wong SK. Castleman's disease of the kidney: Sonographic findings. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:438-442. [PMID: 24947075 DOI: 10.1002/jcu.22192] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 03/04/2014] [Accepted: 06/03/2014] [Indexed: 06/03/2023]
Abstract
We report a case of rare Castleman's disease of the kidney that mimicked a renal neoplasm with emphasis on the imaging and histologic findings. A 47-year-old man presented with dyspeptic symptoms. Ultrasound revealed a vascular, heterogeneous mass in the left kidney. Multiphasic CT scan confirmed an enhancing lesion with enlarged left para-aortic lymph nodes suspicious for nodal metastases. The provisional diagnosis was renal cell carcinoma. Percutaneous biopsy yielded a diagnosis of Castleman's disease of the hyaline-vascular type. Despite advancement in imaging modalities, differentiation of hyaline-vascular variant of Castleman's disease from hypervascular renal neoplasm remains difficult and the final diagnosis requires histopathological confirmation.
Collapse
Affiliation(s)
- Chin Chin Ooi
- Department of Diagnostic Radiology, Singapore General Hospital, Block 2, Level 1, Outram Road, Singapore, 169608
| | - Foong Koon Cheah
- Department of Diagnostic Radiology, Singapore General Hospital, Block 2, Level 1, Outram Road, Singapore, 169608
| | - Siew Kune Wong
- Department of Diagnostic Radiology, Singapore General Hospital, Block 2, Level 1, Outram Road, Singapore, 169608
| |
Collapse
|
4
|
Jayant K, Agrawal S, Agrawal R. Retroperitoneal Castleman's disease: benign in the midst of malignancy. BMJ Case Rep 2014; 2014:bcr-2013-203067. [PMID: 24700042 DOI: 10.1136/bcr-2013-203067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 32-year-old asymptomatic woman presented with localised mass on the left side of the abdomen for 8 months. An abdominal ultrasound and CT scan revealed a solid heterogenous mass located just below the left kidney in the retroperitoneum. Provisional diagnosis of soft tissue sarcoma was made. Following this, surgery was planned and open biopsy (frozen section) was performed, which demonstrated localised hyaline-vascular type of Castleman's disease, which was then excised completely. Thus, intraoperative diagnosis avoided extensive resection and radiation therapy, which reduced the patient's morbidity and expenses. Postoperative period was uneventful and no recurrence was seen even after 3 years of follow-up.
Collapse
Affiliation(s)
- Kumar Jayant
- Department of General Surgery, Sudha Hospital & Medical Research Center, Kota, Rajasthan, India
| | | | | |
Collapse
|
5
|
A Rare Coexistence of Retroperitoneal Pararenal Castleman's Disease with Focal Nodular Hyperplasia. Case Rep Surg 2013; 2013:537593. [PMID: 23533915 PMCID: PMC3603638 DOI: 10.1155/2013/537593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/14/2013] [Indexed: 11/17/2022] Open
Abstract
Castleman's disease is a distinct form of lymph node hyperplasia divided into a solitary and a multicentric type. The solitary type occurs most commonly in the mediastinum and is usually asymptomatic. We present a patient with Castleman's disease of the hyaline-vascular solitary type located in the retroperitoneum.
The patient was a 38-year-old male, who presented to our hospital with fever. The imaging workup revealed a retroperitoneal mass, measuring 4 × 6 cm, located lateral to the aorta, inferior to the left renal artery and vein, and posterior to the left testicular vein. At workup, a solid hepatic lesion, 3 cm in diameter, located in the left lobe of the liver, segment IV, was also identified. Both lesions were surgically excised. The retroperitoneal tumor had the features of angiofollicular hyperplasia (Castleman's disease), hyaline-vascular type, whereas a diagnosis of focal nodular hyperplasia was made for the hepatic lesion. The patient is well at fourty months followup postoperatively. Surgical excision is the treatment of choice for unifocal Castleman's disease.
Collapse
|
6
|
Sato A. Castleman's disease in the pelvic retroperitoneum: A case report and review of the Japanese literature. Int J Surg Case Rep 2012; 4:19-22. [PMID: 23103628 DOI: 10.1016/j.ijscr.2012.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 08/08/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Castleman's disease is a fairly rare benign tumor of lymphoid origin. It can develop anywhere lymphoid tissue is found, but the expected origin is mediastinum and rarely pelvic retroperitoneum. PRESENTATION OF CASE A 22-year-old woman was admitted to our hospital for a mass in the pelvic retroperitoneum that was detected incidentally on an ultrasonography during a routine medical checkup with no signs of symptoms. After laboratory examination, ultrasonography, and magnetic resonance imaging (MRI), surgical resection was performed successfully through a lower midline incision. But the patient was needed transfusion because of massive bleeding. Postoperative histopathological diagnosis was hyaline-vascular type of Castleman's disease. The patient is leading an active social life without any signs of sequelae or recurrence. DISCUSSION Through the review of Japanese literature on Castleman's disease in the retroperitoneum, the characteristics of preoperative imaging findings are studied. Castleman's disease is easily misdiagnosed clinically because of its scarcity and no specific imaging findings. And the embolization via angiography should be considered in the hypervasular tumors such as in this case to prevent massive bleeding and transfusion. CONCLUSION Although Castleman's disease is uncommon, it should always be included in the differential diagnosis of pelvic retroperitoneal tumors. A better knowledge of this disease would help surgeon to avoid unnecessarily extensive resection and massive bleeding for transfusion when dealing with retroperitoneal tumors.
Collapse
Affiliation(s)
- Atsushi Sato
- Department of Gastroenterological Surgery, Toyota Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi 471-8513, Japan.
| |
Collapse
|
7
|
A retrospective study of unicentric and multicentric Castleman's disease: a report of 52 patients. Med Oncol 2009; 27:1171-8. [PMID: 19937164 DOI: 10.1007/s12032-009-9355-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2009] [Accepted: 10/27/2009] [Indexed: 01/24/2023]
Abstract
Castleman's disease (CD) is a rare disorder characterized by non-cancerous tumor growth that may develop in the lymph node tissue at a single site or throughout the body (Castleman et al. in Cancer 9:822-830, 1956). It involves hyperproliferation of specific B cells that produce the cytokine IL-6. This disorder is often undiagnosed or misdiagnosed. For this reason, only very few patients have been reported, and little information is available in the literature. In hopes of providing a better understanding of this rare disease, this report examines 52 patients with Unicentric Castleman's disease (UCD) and Multicentric Castleman's disease (MCD) treated from 1999-2008 at a single institution. Fifty-two patients with CD, along with their histological diagnoses, were collected. Patients were divided into two groups--the more common UCD and the less common MCD. Relevant clinical, pathological, and laboratory data were examined in order to evaluate treatment responses, with symptom onsets and survival period serving as the endpoints of the assessment. Each of the 48 patients with UCD exhibited benign symptoms and underwent a curative surgical resection with excellent prognosis. All of the four patients with MCD received surgical resection. Three of the four patients relapsed and received radiotherapy and/or chemotherapy. Only one of the three post-treatment patients survived. UCD is manifested in the form of benign, painless, slow lymph node enlargement that is generally asymptomatic. Complete surgical removal is recommended as a course of curative treatment. The multicentric form of CD exhibits a progressive clinical course with potential for malignancy. There is currently no standard therapy for MCD.
Collapse
|
8
|
Hata T, Ikeda M, Ikenaga M, Yasui M, Shingai T, Yamamoto H, Ohue M, Sekimoto M, Hoshida Y, Aozasa K, Monden M. Castleman's disease of the rectum: report of a case. Dis Colon Rectum 2007; 50:389-94. [PMID: 17171476 DOI: 10.1007/s10350-006-0783-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gastrointestinal Castleman's disease is very rare. We report the case of a 52-year-old patient with asymptomatic rectal polyp, which was diagnosed as Castleman's disease. The rectal polyp was identified during preoperative workup of gastric adenocarcinoma. The rectal polyp was 4-cm long with a short, thick stalk. Pathologic examination of the resected polyp showed lymph follicle hyperplasia with remarkable lymphocyte and plasma cell infiltration in the submucosal area, consistent with plasma cell type of Castleman's disease. This is the first report of Castleman's disease of the rectum concomitant with gastric adenocarcinoma. A literature review of Castleman's disease identified only five cases of gastrointestinal Castleman's disease, and all five cases were of the hyaline vascular type. A high index of suspicion of this disease is important for preoperative diagnosis.
Collapse
Affiliation(s)
- Taishi Hata
- Department of Surgery and Clinical Oncology, Osaka University, Osaka, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Bucher P, Chassot G, Zufferey G, Ris F, Huber O, Morel P. Surgical management of abdominal and retroperitoneal Castleman's disease. World J Surg Oncol 2005. [PMID: 15941478 DOI: 10.1186/+1477-7819-3-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Abdominal and retroperitoneal Castleman's disease could present either as a localized disease or as a systemic disease. Castleman's disease is a lymphoid hyperplasia related to human Herpes virus type 8, which could have an aggressive behavior, similar to that of malignant lymphoid neoplasm mainly with the systemic type, or a benign one in its localized form. METHODS The authors report two cases of localized Castleman's disease in the retroperitoneal space and review the current and recent progress in the knowledge of this atypical disease. CASES PRESENTATION The two patients were young healthy women presenting with a hyper vascular peri-renal mass suggestive of malignant tumor. Both have been resected in-toto. One of them had an extensive resection with nephrectomy, while the second had a kidney preserving surgery. Pathological examination revealed localized Castleman's disease and surgical margins were free of disease. Postoperative course was uneventful, and after more than 5-years of follow-up no recurrences have been observed. CONCLUSION Localized Castleman's disease should be considered when facing a solid hypervascular abdominal or retroperitoneal mass. A better knowledge of this disorder and its characteristic would help surgeon to avoid unnecessarily extensive resection for this benign disorder when dealing with abdominal or retroperitoneal tumors. Surgical resection is curative for the localized form, when complete, while splenectomy could be indicated for the systemic form.
Collapse
Affiliation(s)
- Pascal Bucher
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland.
| | | | | | | | | | | |
Collapse
|
10
|
Bucher P, Chassot G, Zufferey G, Ris F, Huber O, Morel P. Surgical management of abdominal and retroperitoneal Castleman's disease. World J Surg Oncol 2005; 3:33. [PMID: 15941478 PMCID: PMC1166581 DOI: 10.1186/1477-7819-3-33] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 06/07/2005] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Abdominal and retroperitoneal Castleman's disease could present either as a localized disease or as a systemic disease. Castleman's disease is a lymphoid hyperplasia related to human Herpes virus type 8, which could have an aggressive behavior, similar to that of malignant lymphoid neoplasm mainly with the systemic type, or a benign one in its localized form. METHODS The authors report two cases of localized Castleman's disease in the retroperitoneal space and review the current and recent progress in the knowledge of this atypical disease. CASES PRESENTATION The two patients were young healthy women presenting with a hyper vascular peri-renal mass suggestive of malignant tumor. Both have been resected in-toto. One of them had an extensive resection with nephrectomy, while the second had a kidney preserving surgery. Pathological examination revealed localized Castleman's disease and surgical margins were free of disease. Postoperative course was uneventful, and after more than 5-years of follow-up no recurrences have been observed. CONCLUSION Localized Castleman's disease should be considered when facing a solid hypervascular abdominal or retroperitoneal mass. A better knowledge of this disorder and its characteristic would help surgeon to avoid unnecessarily extensive resection for this benign disorder when dealing with abdominal or retroperitoneal tumors. Surgical resection is curative for the localized form, when complete, while splenectomy could be indicated for the systemic form.
Collapse
Affiliation(s)
- Pascal Bucher
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| | - Gilles Chassot
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| | - Guillaume Zufferey
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| | - Frederic Ris
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| | - Olivier Huber
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| | - Philippe Morel
- Clinic of Visceral and Transplantation Surgery, Department of Surgery, Geneva University Hospital, Switzerland
| |
Collapse
|
11
|
Hsieh CH, Changchien CC, Lan KC, Huang CC, Shen CC, Chang SY, Lin H. Pelvic Castleman's disease presenting as an adnexal tumor. Acta Obstet Gynecol Scand 2004; 83:311-3. [PMID: 14995930 DOI: 10.1111/j.0001-6349.2004.0089a.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Chin-Hsiung Hsieh
- Division of Gynecologic Oncology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan
| | | | | | | | | | | | | |
Collapse
|
12
|
Malara FA, Price D, Fabiny R. Mesenteric Castleman's disease: ultrasound, computed tomography and angiographic appearance. AUSTRALASIAN RADIOLOGY 2000; 44:109-11. [PMID: 10761270 DOI: 10.1046/j.1440-1673.2000.00753.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The localized form of Castleman's disease is rare, and a mesenteric location is particularly unusual. A case of an asymptomatic young woman having the hyaline vascular type is presented and the ultrasound, CT and angiographic features of the condition are demonstrated.
Collapse
Affiliation(s)
- F A Malara
- Department of Radiology, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
| | | | | |
Collapse
|