Small-intestinal Castleman disease mimicking a neoplastic lesion: a case report

Abstract

Castleman disease (CD) encompasses a group of rare lymphoproliferative disorders with diverse clinical presentations, histopathological features, and treatment approaches. This most commonly involves the mediastinal lymph nodes. Involvement of the small intestine is exceedingly uncommon and it often mimics more prevalent pathologies such as gastrointestinal stromal tumours (GIST), lymphoma, or neuroendocrine tumours. Early recognition is essential as surgical excision is typically curative in unicentric disease. A 38-years old male presented with complaints of dull aching pain in left upper abdomen for 1 year. CECT abdomen showed a soft tissue mass in the left lumbar region suggesting of neoplastic etiology. He underwent laparoscopic jejunal mesenteric soft tissue tumour excision with resection and anastomosis of jejunum. Post operative biopsy was suggestive of CD. CD of the small intestine is exceptionally rare and it is often misdiagnosed as other small bowel tumours. Pre-operative identification is extremely challenging due to non-specific clinical and radiological findings. Complete surgical excision remains the cornerstone of management for unicentric disease and is associated with excellent outcomes.