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Castleman's Disease Presenting as an Unusual Pelvic Retroperitoneal Mass.

Cureus

October 2024

General Surgery, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, IND.

Castleman's disease (CD) is characterised by benign lymphoepithelial proliferation and is a peculiar form of angiofollicular lymph node hyperplasia rather than a neoplasm or a hamartoma. CD is broadly classified as unicentric CD (UCD) and multicentric CD. In the unicentric variant, patients have localised disease affecting only a single lymph node or a group of adjacent nodes in a single region, which clinically presents as an enlarging mass without any other significant symptoms.

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Castleman disease (CD), also known as giant lymph node hyperplasia or angiofollicular lymph node hyperplasia, is a rare and indeterminate group of chronic lymphoproliferative disorders. CD is highly heterogeneous, classified into unicentric Castleman disease (UCD) and multicentric Castleman disease (MCD) based on lesion distribution, and further categorized into three pathological types: hyaline vascular type (HV), plasma cell type (PC), and mixed type (Mix). This paper describes a rare case of solitary mediastinal Castleman disease with transparent vessels in the anterior sacrum, presenting as the HV type.

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Solitary fibrous tumours (SFTs) usually occur at the pleura. Extrapleural sites, particularly giant extrapleural solitary fibromas, are more rarely observed in the clinic, and the clinical diagnosis and treatment of this disease is a focus of attention. Herein, the case of a 43-year-old male patient with giant presacral SFT successfully treated by open surgery, and with a final diagnosis confirmed by postoperative pathology and immunohistochemistry, is reported.

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Huge primary epidural solitary fibrous tumors in the sacrum are a rare clinical entity. The purpose of this article is to present our experience in treating such large and complex neoplasms in a 31-year-old woman. The patient complained of constant nocturnal bilateral hip and lower back pain and unilateral radicular symptoms (numbness, paresthesias) in the left S1/S2 dermatomal distribution.

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Schwannomas are benign nerve sheath tumors that are generally encapsulated and commonly detected in the head, neck, and mediastinal regions. Schwannomas localizing in the pelvis are extremely rare and tend to be asymptomatic initially due to slow growth rate. Schwannomas may be misdiagnosed as urologic or gynecologic tumors.

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