Retroperitoneal localization of Castelman's disease in a pediatric patient: case report

Autor: Šlabek, Ema, Nikolić, Harry, Bosak Veršić, Ana
Jazyk: chorvatština
Rok vydání: 2022
Předmět:
Zdroj: Medicina Fluminensis : Medicina Fluminensis
Volume 58
Issue 1
Medicina Fluminensis
ISSN: 1848-820X
1847-6864
Popis: Cilj: Castelmanova bolest rijetko je oboljenje koje karakterizira benigna hiperplazija limfnih čvorova. Glavni je cilj prikazati Castelmanovu bolest kao mogući uzrok retroperitonealne tvorbe u pedijatrijskoj populaciji. Prikaz slučaja: Na Zavod za hematologiju, onkologiju i kliničku genetiku Klinike za pedijatriju Kliničkog bolničkog centra Rijeka zaprimljen je petnaestogodišnji dječak radi verifikacije ekspanzivne tvorbe u području burze omentalis, koja je utvrđena ultrazvukom prilikom obrade recidivirajućeg povraćanja. Naime, dječak je deset dana pred prijam svakodnevno povraćao ujutro nakon doručka u tri do četiri navrata. Ultrazvučno je bila prikazana dobro ograničena tvorba promjera 4 x 3 cm između duodenuma i pankreasa. Kompjutoriziranom tomografijom prikazala se tvorba koja se utiskivala u želudac bez znakova infiltracije okolnih struktura. Prema karakteristikama tvorbe vidljivih magnetskom rezonancijom zaključilo se da se radi o solitarnoj benignoj tvorbi. Učinjena je iglena punkcija pod kontrolom endoskopskog ultrazvuka, a na temelju citološkog nalaza postavila se klinička sumnja na Castelmanovu bolest hijalino-vaskularne varijante. Napravljena je kirurška ekstirpacija tvorbe što je ujedno i standard liječenja unicentrične Castelmanove bolesti. Patohistološka analiza potvrdila je radnu dijagnozu unicentrične Castelmanove bolesti miješane varijante. Poslijeoperacijski tijek prošao je uredno i dječak je otpušten kući dobrog općeg stanja. Na redovnim kontrolama nije bilo znakova recidiva osnovne bolesti. Zaključak: Iako je Castelmanova bolest rijetka, pogotovo retroperitonealne lokalizacije i u pedijatrijskoj populaciji, treba ju uvrstiti u diferencijalnu dijagnozu pri pronalasku tumorske tvorbe na toj lokalizaciji.
Aim: Castelman's disease is a rare condition characterized by benign lymph node hyperplasia. The aim of this paper is to present Castelman's disease as a possible cause of retroperitoneal mass in the pediatric population. Case report: A fifteen-year-old boy was admitted to the Department of Pediatric Hematooncology for verification of an expansive formation in the area of omental bursa. The formation was detected by ultrasound during diagnostics due to recurrent vomiting. The boy complained of vomiting during ten days before admission, three to four times daily, usually after breakfast. Ultrasound showed a well-limited formation 4 x 3 centimeters in diameter located between the duodenum and pancreas. Computed tomography confirmed localisation of the tumor showing no signs of infiltration of surrounding structures and magnetic resonance imaging reported benign characteristics. Endoscopic ultrasound guided needle biopsy was preformed and a clinical presumption of a hyaline-vascular variant Castelman's disease was made. Surgical extirpation was performed. Complete tumor resection is a standard treatment for unicentric Castelman's disease. The pathological analysis confirmed the diagnosis of unicentric mixed variant Castelman's. Postoperative recovery went smoothly and the boy was discharged home in good general condition.There were no signs of recurrence of the underlying disease at regular check-ups. Conclusion: Although Castelman's disease is rare, especially localized retroperitoneally and in pediatric population, it should be included in the differential diagnosis when considering retroperitoneal tumorous formations.
Databáze: OpenAIRE
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