Castleman Disease Mimicking Ovarian Tumour

Abstract

Castleman disease is a lymphoid disease characterized by herpes virus infection associated hyperplasia of lymphatic tissue. Castleman disease is generally localized in the mediastinum (70%) and the regions that it may be seen outside of the thorax are neck, axilla, pelvis and retroperitoneum. Castleman disease may present unicentrically or multicentrically.
Fifty-six year old postmenopausal woman was detected to have a right adnexial mass in her routine gynecological examination. This adnexial mass was also observed in the pelvic ultrasonography and pelvic magnetic resonance imaging (MRI). A retroperitoneal mass was detected in the right hemipelvis. Pathological evaluation revealed Castleman disease, hyaline vascular type. Any lymphadenopathy other than this wasn’t observed in the systemic imaging of the patient. Therefore, she was considered to have unicentric disease and was told to come to follow-up visits.
Castleman disease is a rare condition. Since symptoms and imaging findings aren’t specific to the disease, preoperative diagnosis is quite difficult. Castleman disease located in the pelvic retroperitoneum may mimic adnexial masses. It is genearlly related to pelvic walls and iliac vessels. Surgical removal of unicentric Castleman disease is curative.
While Castleman disease is observed rarely in gynecological practice, it should be kept in mind in the differential diagnosis of adnexial masses.