A Rare Case of Pelvic Castleman's Disease Mimicking an Adnexal Tumor

Castleman’s disease (CD) is a rare disease which is defined as non-malignant proliferation of lymphofollicular tissue and mainly seen in mediastinum and head-neck origin. It can reach giant size which can mimick the tumoral process (1). Its etology is still unknown and few cases in pelvic origin have been reported in the literature. Castleman firstly defined the disease by two microscopic features, lymphoid follicular hyperplasia and proliferation of microvascular structures with endothelial hyperplasia. Clinically, CD can be seen as two forms of unicentric CD (UCD) or multicentric with more systemic B-like symptoms. On literature search it was found that the most common locations of CD are the mediastinum (63%), abdominal cavity (11%), retroperitoneal region (7%), axilla (4%), and perirenal space (2%) (2). Although the mediastinal involvement is the most common form, the genitourinary localization is highly infrequent and sometimes it creates great challenges during diagnosis and treatment management (3). The main issue in pelvic CD is its mimicking capacity with regard to pelvic adnexial tumor either benign or malignant. And also, it is usually diagnosed postoperatively by histopathologic examination due to its rare occurrence and localization in pelvic region (4). So, with our case report, we want to report a woman with pelvic CD mimicking an adnexial tumor diagnosed postoperatively and to present its successful management with diagnostic imaging tools.