AlSheikh S, Altoijry A, Al-Mubarak H, Alsallum OD, Alakeel F, Alanezi T. A rare presentation of unicentric Castleman's disease in the thigh: A case report and review of literature. World J Clin Cases 2024; 12(19): 4003-4009 [PMID: 38994289 DOI: 10.12998/wjcc.v12.i19.4003]
Corresponding Author of This Article
Tariq Alanezi, MD, Doctor, Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Ash Shaikh Hasan Ibn Abdullah Al Ash Shaikh Road, Riyadh 11322, Saudi Arabia. alanezitariq@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Sultan AlSheikh, Abdulmajeed Altoijry, Husain Al-Mubarak, Ofays Dakkam Alsallum, Tariq Alanezi, Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia
Ofays Dakkam Alsallum, Division of Vascular Surgery, Department of Surgery, King Khalid Hospital Najran, Najran 11321, Saudi Arabia
Fadi Alakeel, Department of Pathology, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia
Author contributions: AlSheikh S, Altoijry A and Al-Mubarak H designed the research study; Alanezi T completed the first draft of this manuscript and performed the experiments and data collection; Alsallum OD and Alanezi T was involved in data collection; Alakeel F provided pathological findings; AlSheikh S, Altoijry A, Al-Mubarak H, Alsallum OD, lakeel F and Alanezi T revised the manuscript. All authors have read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images. A copy of the written consent form is available for review by the editor-in-chief of this journal upon request.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tariq Alanezi, MD, Doctor, Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Ash Shaikh Hasan Ibn Abdullah Al Ash Shaikh Road, Riyadh 11322, Saudi Arabia. alanezitariq@gmail.com
Received: March 6, 2024 Revised: May 8, 2024 Accepted: May 21, 2024 Published online: July 6, 2024 Processing time: 114 Days and 19.3 Hours
Abstract
BACKGROUND
Castleman's disease (CD) is a rare lymphoproliferative, emulating both benign and malignant diseases. The diagnosis of CD is formulated upon the combination of clinical and laboratory criteria and ultimately confirmed by histopathological assessment. Due to its rarity, CD presents a challenge in treatment selection, with available options encompassing surgery, chemotherapy, and autologous stem cell transplantation. However, studies suggest that surgical resection of the lesion is the most effective treatment modality, especially for unicentric CD (UCD).
CASE SUMMARY
Here, we describe the case of a 25-year-old woman who presented with painless left thigh swelling for 10 wk. She had been following a low-fat diet to lose weight and had normal laboratory results. Magnetic resonance imaging revealed a well-circumscribed, demarcated cystic lesion located in the left inguinal region with eccentrically positioned signal void vascular structures, measuring 4.3 cm × 3 cm × 3.2 cm, likely of lymphoid origin. The patient underwent surgical resection, and the final histopathology showed a vascular proliferation and hyalinization of the vessel walls, along with atretic germinal centers traversed by penetrating vessels, consistent with CD. The patient was discharged home one day after the procedure in good condition, with a follow-up appointment scheduled in our outpatient clinic.
CONCLUSION
Although surgical resection is the mainstay for UCD, a multidisciplinary approach is needed due the lack of specific diagnostic features and treatments.
Core Tip: Castleman's disease (CD) is a rare disorder primarily affecting lymph nodes and associated tissues. Clinical characteristics and survival vary significantly among the three histological subtypes of CD. Diagnosis of CD primarily relies on histopathological examination, supported by imaging modalities such as computed tomography scan, magnetic resonance imaging, and ultrasound. Histopathological examination is crucial for diagnosing both unicentric-CD (UCD) and multicentric-CD, especially after ruling out other disorders, including infections, malignancies, and autoimmune conditions. Despite its rarity, CD presents a range of treatment options. However, studies consistently highlight surgical resection as the optimal treatment modality, particularly for UCD.
