Mesentery root: a rare location of Castleman’s disease

Abstract

Castleman’s disease (CD) is a rare disorder that involves the lymphoid system and can be uni- or multicentric. While it can arise in any organ that contains lymphoid tissue, most commonly is observed in the mediastinum. Abdominal localizations come second, more often in the retroperitoneum. We report the case of a 49-year-old woman presenting with biliary type dyspepsia and early post-prandial satiety whose imaging evaluations revealed uncomplicated cholelithiasis and a 3.5 cm nodule situated at the root of the mesentery. The patient was treated with surgery – cholecystectomy and en bloc resection of the mesenteric root mass. Histology exam of the surgical specimen concluded for a hyaline-vascular type CD, also confirming the negative resection margins of the tumor. Postoperatively, the patient’s evolution was favorable, with discharge at the 5th postoperative day. No adjuvant treatment was necessary. The hematology evaluation excluded any underlying lymphoproliferative disorder or chronic viral infection. One year after surgery, the patient has no recurrence.