Castleman disease of the abdomen--single-center experience of 13 surgically treated patients over 11 years
Castleman disease (CD) is a lymphocytic hyperplastic disease, also known as angiofollicular lymphoid hyperplasia and giant lymph node hyperplasia, which rarely occurs in the abdomen. We analyzed the clinical manifestations in 13 patients treated surgically at our center for abdominal CD lesions. We retrospectively reviewed the medical records of 13 patients with abdominal CD who underwent surgery at our institution in the 11-year period from January 1998 to May 2009. Of the 13 patients, 8 were women; their mean +/- SD age was 47.1 +/- 12.0 years. CD was incidentally found in seven patients with no symptoms. Only 3 patients were preoperatively suspected of CD, with 10 suspected of other diseases. Twelve of the 13 patients (92.3%) underwent excisional surgery, with 11, 1 and 1 undergoing R0, R1, and R2 resections, respectively. Eleven tumors were hyaline vascular type and two were plasma cell type. After a mean follow-up of 63.3 months, only one patient showed recurrence, but this patient remains progression-free 7 years after repeat resection. Abdominal CD is a rare disease that is often misdiagnosed due to the absence of specific clinical manifestations. Definitive diagnosis requires histologic examination of the surgical specimen. Excisional surgery is the method of choice for unicentric abdominal CD, and is associated with a low incidence of recurrence.