Intracranial Localized Castleman's Disease-Case Report-

Abstract

A 68-year-old woman presented with generalized clonic seizure following a 2-month history of initiative loss, incoherent speech, headache, and left hemiparesis. No systemic signs or symptoms were seen and laboratory studies were within normal range. Computed tomography and magnetic resonance imaging demonstrated a well-delineated small mass with homogeneous enhancement in the right parietal convexity, associated with unusually extensive perifocal edema compared to the size of the mass. Cerebral angiography showed a faint stain fed by the middle meningeal artery. These imaging features were very similar to those of meningioma. Full recovery from the symptoms was achieved by total removal of the lesion and no recurrence was found after 3 years. Histological examination identified the hyaline-vascular type of angiofollicular lymph node hyperplasia (Castleman's disease). Castleman's disease involving the central nervous system is rare, with only 12 previous cases, but should be considered in the diagnosis of intracranial meningeal tumors. The treatment of choice for localized Castleman's disease is complete surgical resection, which is curative in most of the cases.

Castleman’s disease associated with mixed connective tissue disorder and cerebral ischaemia and vasculitis: A rare case and a diagnostic challenge for an infectologist

“…Castleman's disease is rarely diagnosed in the CNS, with only 13 cases in the literature until year 2005. The origin of intracerebral CD was explained by dendritic cells' participation in immune disregulation in MCD 13,14 .…”

Solitary Intracranial Castleman’s Disease, Plasma Cell Variant: A Case Report

“…Total surgical excision, radiotherapy or a combination of both are considered adequate for solitary intracranial CD [4][5][6][7][8][9][10] . The present case was managed by surgery and low dose local radiotherapy.…”

“…To the best of our knowledge, only 12 cases of solitary intracranial CD have been reported in the medical literature so far [4][5][6][7][8][9][10] . In all cases, it was mistaken both clinically and radiologically as a meningioma.…”

Differential Diagnosis between Neoplastic and Non-Neoplastic Brain Lesions in Radiology

“…The plasma cell type represents only 5% to 10% of cases, and is characterized by large lymphoid follicles separated by sheets of mature plasma cells and less stromal vascularization. 36 Localized forms of the disease are generally asymptomatic, while the generalized form may present with fever, weight loss, anemia, polyneuropathy, organomegaly, and monoclonal proteinemia, thus resembling a paraneoplastic syndrome. Intracranial Castleman disease is very rare, with 13 cases described in the literature, and in this locality it may mimic a neoplasm, in particular a meningioma.…”