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Introduction: Castleman's disease is a rare nonclonal lymphoproliferative disorder of unknown etiology that most commonly affects the mediastinum. It is classified into two clinical subtypes: A localized (unicentric) subtype and a multifocal (multicentric) subtype. This case report presents an adolescent with unicentric mesenteric Castleman's disease, which is very rare. Case Presentation: A 14-year-old girl presented to our center with chronic left flank pain. She also reported frequent episodes of small-volume vaginal bleeding outside her menstrual period. Initially, she was treated for several weeks with a possible diagnosis of dysmenorrhea due to an ovarian cyst. However, due to the lack of response to treatment and persistent symptoms, further investigation was conducted. Abdominal and pelvic ultrasonography revealed a round, hypoechoic, and heterogeneous mass measuring 22 × 35 mm in the left mesentery with regular margins. Pathological examination confirmed Castleman's disease of the hyaline-vascular type. The patient was discharged in good general condition and with stable vital signs. During follow-up, her abdominal symptoms and bleeding resolved, and no lesions were detected on ultrasonography and CT scans at 6 and 12 months. Conclusions: Mesenteric Castleman's disease is rare and presents a diagnostic challenge. This disease should be included in the differential diagnosis of abdominal tumors, even in symptomatic cases. The treatment of choice for unicentric cases is surgery.
Nasirabadi et al. (Sat,) studied this question.