Pelvic Castleman disease mimicking an adnexal tumor

BACKGROUND: Castleman disease, or giant lymph node hyperplasia, is a rare cause of lymph node enlargement. Only 11 cases with pelvic localization in women have been reported. CASE: A pelvic mass mimicking an adnexal tumor was detected on a routine examination in a 26-year-old woman. Surprisingly, the pelvic organs were found to be normal at laparotomy. Eight years later, the subject was examined for dyspareunia and secondary infertility that lasted 2 years. A pelvic mass, evidently the one encountered 8 years previously, was detected; it had enlarged only slightly in the intervening time. Surgical exploration of the retropubic space revealed a tumor-like mass attached to the periosteum of the left superior pubic arch. The mass was removed by simple resection. Histologic investigations confirmed a diagnosis of Castleman disease. Three months after the operation, the woman conceived without any further treatment. CONCLUSION: The possibility of Castleman disease should be considered when assessing a pelvic mass. The condition in the retropubic space in women has not been reported previously.