A case of castleman disease treated by single incision laparoscopic resection

Abstract

A 32-year-old female visited a hospital because of epigastralgia. Abdominal ultrasonography and abdominal computed tomography (CT) revealed an intra-abdominal tumor. She was referred to our hospital for diagnosis and treatment. The 35×30mm tumor was located in the great omental space. The tumor was homogenously enhanced on abdominal CT. In order to obtain a definite diagnosis and perform adequate treatment, a diagnostic single incision laparoscopy (single 25mm horizontal incision at the lower edge of umbelicus) was performed. The resected tumor was histopathologically confirmed to be Castleman's disease of the hyaline-vascular type. The post-operative course was uneventful and the patient was discharged on postoperative day 7. It is very difficult to diagnose a small abdominal tumor. The diagnosis was achieved only by histologic evaluation of the surgical specimen. The single incision laparoscopic approach alloweel resection of the lesion with consequent histological diagnosis and exploration of the peritoneal cavity with the advantages of minimal invasiveness. The pathology was thereby totally resolved with satisfactory results in terms of recovery, postoperative pain, and cosmetics.