NDP067: Extraperitoneal laparoscopic repair of huge inguinoscrotal bladder hernia: A case report and literature review
骨盆腔卡斯爾曼氏病：病例報告
陳子双1、鄭元佐1
1高雄長庚紀念醫院 泌尿科
Castleman's disease in the pelvis: A case report
Tzu-Shuang Chen1, Yuan-Tso Cheng1
Department of Urology1, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
Introduction:
Castleman’s disease (CD), also known as angiofollicular lymphoid hyperplasia, is a rare benign lymphoproliferation disorder with unknown etiology. CD is classified as unicentric CD or multicentric CD clinically. Unicentric CD is most commonly found at mediastinum, abdomen and retroperitoneal regions. Among localized CD in the retroperitoneal, the pelvic CD is the rarest. There are three histopathological subtypes, hyaline vascular (HV) , plasmacytic (PC) and mixed type. HV type accounts for 80-90% of cases and dominates in unicentric CD, whereas the PC group is more common in multicentric CD and accounts for 10-20% of cases. Here, we report a case of CD presented as a pelvic retroperitoneal mass.
Case presentation:
A 41-year-old female presented with left lower abdominal pain for one year. A pelvic mass was found by sonography at another hospital and she was referred to our hospital. She denied any other discomfort, such as fever, vaginal discharge, weight loss, change of bowel habits or lower urinary tract symptoms. Computed tomography (CT) scan revealed a well-defined enhancing mass 60x38 mm with calcifications along the left iliac vessels. No enlarged pelvic lymph node. Radiological differential diagnosis is neurofibroma or hemangioma. Laboratory test did not reveal abnormal findings. The patient received transperitoneal approached Robot-assisted laparoscopic surgery for tumor resection. The well-capsulated mass was found located extraperitoneally between peritoneal and left iliac vessels. The encapsulated tumor was complete resected uneventfully after control of multiple feeding vessels orginated from external iliac artery and vein. The excised mass was measured 7.5x1.8x0.7 cm. It confirmed the diagnosis of HV type CD under microscopic examination. There was no evidence of recurrence 9 months after operation.
Conclusions:
Pelvic CD is extremely rare so it should be considered as an important differential diagnosis of masses located in the pelvic area. Complete surgical resection provides good prognosis for unicentric pelvic CD.