Laparoscopic Treatment of Unicentric Castleman's Disease with Abdominal Localization

Abstract

We report a case of unicentric Castleman's disease (angiofollicular lymph node hyperplasia) with abdominal localization, that was treated laparoscopically. The patient, a 23-year-old male, was referred to our unit for subtle symptoms of recurrent palpitations and vague abdominal pain. His physician had prescribed an abdominal echtomograph, which showed a mass located at the lower and anterior lower splenic pole. In order to reach a definite diagnosis and prescribe adequate treatment, a diagnostic laparoscopy was performed. Exploration of the abdominal cavity helped detect a well-vascularized solid round mass at the level of the left hypochondrium, with a vascular pedicle; the lesion was detached, and the pedicle sectioned using an Endo-GIA 40. The postoperative course was regular and the patient was discharged on postoperative day 2. The laparoscopic approach enabled the resection of the lesion (with consequent histological diagnosis) and exploration of the peritoneal cavity with the advantages of minimal invasiveness, magnified images, and more rapid recovery). The pathology was totally resolved, with satisfactory results in terms of recovery, postoperative pain, and cosmesis.

Laparoscopically resected Castleman's disease in the pelvic retroperitoneum: A case report

“…Although several cases of unicentric Castleman's disease in the abdominal cavity treated laparoscopically have been reported (36,37), to the best of our knowledge, only one report on female pelvic retroperitoneal Castleman's disease treated by laparoscopy is available in literature (Table I) (16). As some masses are well vascularized and adjacent to the great vessels, laparoscopy can provide magnified images that facilitate and secure dissection.…”

Clinicopathological characteristics of unicentric retroperitoneal Castleman’s disease: a study of 14 cases

“…Bowne et al studied 16 cases of CD and reported that no clinical or radiographic recurrence of symptoms was found among the 8 of 16 cases of unicentric hyaline-vascular disease patients who underwent complete surgical excision [ 9 ]. There are several reports that unicentric CD in the abdominal cavity were treated laparoscopically [ 11 , 12 ]. Some masses are well vascularized and adjacent to the great vessels [ 11 ]; laparoscopy can offer magnified images to facilitate and secure dissection.…”

“…There are several reports that unicentric CD in the abdominal cavity were treated laparoscopically [ 11 , 12 ]. Some masses are well vascularized and adjacent to the great vessels [ 11 ]; laparoscopy can offer magnified images to facilitate and secure dissection. In our case studies, all the 14 patients with unicentric retroperitoneal CD underwent a complete surgical resection, either open or laparoscopy, and survived with excellent prognosis.…”

Rare Case of Castleman Disease Involving the Pancreas

“…Six were hyaline vascular type and three were plasma cell type. [2][3][4][5][6][7][8][9][10] Eight had resection of localized disease. Laparoscopic resection was performed in one case.…”

“…C ASTLEMAN DISEASE WAS FIRST described in 1954 1 as angiofollicular lymph node hyperplasia, a benign lymphoid disorder commonly presenting as a mediastinal mass. To our knowledge, only nine other cases of Castleman disease involving the pancreas have been described [2][3][4][5][6][7][8][9][10] and it is very rare. We report a case of Castleman disease (unicentric hyalin vascular type) presenting as a pancreatic mass and enlarged spleen.…”