Castleman’s disease of the mesorectum: Report of a case

Abstract

Castleman's disease is a benign lymphoid proliferative disorder, which most commonly presents as a solitary mass in the mediastinum, although extrathoracic sites have been reported in the neck, axilla, pelvis, mesentery, pancreas, and retroperitoneum. We report a case of asymptomatic, isolated Castleman's disease in the mesorectum, which is extremely rare. The patient was a 34-year-old woman who underwent investigations for vaginal spotting. A presacral mass was located on the left side of the rectum, 10 cm from the anal verge. Contrast-enhanced computed tomography showed a large, well-demarcated, strongly enhancing mass with internal radiating septa in the mesorectum. The mass was well circumscribed and isointense to muscle on T1-weighted magnetic resonance imaging, appearing as a slightly hyperintense mass on T2-weighted imaging. We performed laparoscopic mesorectal mass excision, and histological examination revealed features typical of the hyaline-vascular type of Castleman's disease. Thus, when a mesorectal mass is being investigated, Castleman's disease should be considered in the differential diagnosis.

Embolization of blood-supply artery followed by surgery for treatment of mesorectal Castleman’s disease: case report and literature review

“…Rituximab, an anti-CD-20 monoclonal antibody, has achieved significant results in treating CD. Cyclophosphamide, vincristine and doxorubicin are commonly used in combined chemotherapy [4,19–21]. Surgical treatment should be considered as the first option in the focal type of CD.…”

“…CD is usually divided into focal and multicenter types clinically and hyaline vascular type, plasma cell type and mixed type pathologically. It is extremely rare that the focal hyaline vascular type of CD occurs within the mesorectum [4].…”

A Diagnostic Challenge: Pelvic Castleman’s Disease

“…Talat et al [5] found only five in a review of 404 published cases. Pelvic CD is characterized by tumors >5 cm, with predominance of females and hyaline-vascular subtype, and its diagnosis is only possible after surgery, Table 1 [14,[20][21][22][23][24][25][26][27][28][29][30][31][32][33].…”

Castleman’s disease: a rare presacral tumour

“…Gastrointestinal involvement in Castleman’s disease has been reported earlier with involvement of structures like the duodenum, hepatoduodenal ligament, sigmoid colon, rectum and the mesentery [2]. However, presacral disease is very rare, with only one previously reported case in the literature [3].…”