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

Abstract

<i>Objective:</i> We report a case of plasma cell variant of Castleman’s disease confined to the meninges. <i>Clinical Presentation and Intervention:</i> A 53-year-old woman presented with severe headache lasting a few months, which was insidious in onset but followed a progressive course with associated vomiting, blurring of vision and diplopia. Investigations revealed a dural-based mass that was considered both radiologically and intraoperatively as a meningioma. Total surgical excision of the mass was performed. Histologically, it was a plasma cell variant of Castleman’s disease with ĸ light chain restriction. Laboratory investigations and whole body computerized tomography scan showed no significant abnormality. A short course of local radiotherapy was given. The patient is well 2 years after treatment. <i>Conclusion:</i> This report highlights the rarity of solitary intracranial Castleman’s disease and the difficulty in radiological and intraoperative diagnosis.

Resection of unicentric interlobar Castleman disease with following adjuvant radiotherapy

“…In fact, published case reports have confirmed excellent local control rates of unicentric CD with adjuvant radiotherapy (27–50 Gy) in thoracic, 8 , 14 as well as in other regions of the human body including brain. 15 Similarly, in our case of interlobar CD, adjuvant radiotherapy (44 Gy) was used due to the avoidance of the resection of lung parenchyma, tight tumour adherence to pulmonary vessels and possible invasive nature of the disease. After 6 years of follow-up, our patient is still free from local recurrence and do not experience any treatment-related side effects.…”

Rare presentation of Castleman Disease with Leptomeningeal Enhancement Without a Solitary Mass: A Case Report and Literature Review

“…He was found to have a 6.5-centimeter mass that was then surgically resected. This is different compared to our case, where the patient had numbness in his left lower face, left arm, and left leg and hyperesthesia of his left lower extremity which improved on levetiracetam [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. What makes our case unique is the initial MRI finding of leptomeningeal enhancement rather than a discrete, resectable mass.…”

A case of a solitary form of Castleman disease: ten-year follow-up

“…From a diagnostic point of view, it is worth noting that 50-90% of patients with a plasma cell type CD demonstrate hematological disorders such as anemia, leukocytosis, hypergammaglobulinemia, and/or increased concentration of C-reactive protein (CRP) [2]. Particularly, the increased serum concentration of IL-6 is very important, and results in increased IL-6 expression by plasma cells [8]. In the present case, the concentrations of CRP, IL-6 and IL-10 were increased, but the examination was done postoperatively, after histopathological diagnosis.…”

“…In all other reported studies, the etiological diagnosis was made postoperatively and the patients were treat- ed surgically with no regrowth seen after total excision [5][6][7][8][9]. Nevertheless, obtaining an exact preoperative diagnosis could be of advantage because -in contrast to meningioma -also conservative therapeutic options can be considered in some patients with CD.…”

“…Since its first description in 1983 by Lacombe et al, only a few case reports have been published [4][5][6][7][8][9][10]. Intracranial lesions were found to be solitary [5][6][7][8][9]; however, they could also constitute part of a multicentric angiofollicular lymphoid hyperplasia [10]. We present a patient who was referred to us with a diagnosis of intracranial meningioma, which eventually turned out to be a case of localized intracranial CD.…”