Neo-adjuvant chemotherapy followed by radical resection for primary borderline resectable unicentric Castleman disease: a case report

Castleman disease, firstly described in 1954 by Benjamin Castleman, is a group of infrequent benign disorders with the histological trait of lymphatic tissue hyperplasia (1). There are two anatomical subtypes for CD: unicentric Castleman disease (UCD), which confines to one lymphatic region and multicentric Castleman disease (MCD), which presents disease within multiple lymphatic areas (2). Two histopathological subtypes were classified: hyaline vascular type of CD (HVCD) and plasma cell type of CD (PCCD) (3). As a heterogeneous disorder, CD can show completely different symptoms. Most of UCD patients have symptoms associated with surrounding tissue compressed by the tumor. Besides, PCCD is often accompanied by systemic symptoms, such as pyrexia, fatigue, anemia and weight loss due to the persistent over-releasing cytokines like interleukin (IL)-6 (2). Surgery is the curative treatment for UCD when possible. Systemic treatment is generally the first selection of MCD. However, for the unresectable or borderline resectable UCD, no standard treatment was established (4). In the present study, we introduce a successful case showing neo-adjuvant chemotherapy followed by radical resection for a borderline resectable UCD. We present the following case in accordance with the CARE Guideline (5)