# Clinical diagnosis and treatment analysis of 11 cases of unicentric Castleman disease in the retroperitoneum

## TL;DR

This study analyzed 11 cases of rare retroperitoneal unicentric Castleman disease, finding that complete surgical removal leads to excellent long-term outcomes.

## Contribution

The paper provides a detailed clinical analysis of a rare retroperitoneal UCD subtype with long-term follow-up data.

## Key findings

- All 11 patients had no recurrence after complete surgical resection with a mean follow-up of 68 months.
- Retroperitoneal UCD lacked specific symptoms and was often incidentally diagnosed during health check-ups.
- Laparoscopic and open surgeries were both effective with minimal complications and short hospital stays.

## Abstract

To investigate the diagnosis, treatment, and prognosis of unicentric Castleman disease (UCD) located in the retroperitoneum.

A retrospective analysis was conducted on the clinical data of 11 patients with pathologically confirmed retroperitoneal UCD at Peking University People’s Hospital between 2010 and 2025. Data collected included gender, age, clinical manifestations, routine blood tests, tumor markers, treatment modalities, pathological characteristics, and treatment outcomes. Postoperative survival status was assessed via outpatient records and telephone follow-up.

The cohort comprised 3 males and 8 females. One male patient had a history of long-term smoking and alcohol use, while the other 10 patients had no such history. One patient presented with lower back discomfort, one with abdominal discomfort, and the remaining 9 patients were incidentally diagnosed during health check-ups. All patients had serum inflammatory markers and tumor markers within normal ranges. Preoperative abdominal contrast-enhanced CT/MRI localized the lesions in all cases. The mean maximum tumor diameter was 5.23 ± 2.05 cm. Five patients underwent laparoscopic surgery, and six underwent open surgery. The mean operative time was 2.73 ± 1.21 hours, with an intraoperative blood loss of 100 ml (IQR 20–100 ml). No severe postoperative complications occurred. The mean hospital stay was 5.00 ± 1.79 days, and all patients recovered well and were discharged. Pathological examination revealed the hyaline vascular type in 9 cases, the plasma cell type in 1 case, and the mixed type in 1 case. The mean follow-up duration was 68.00 ± 30.41 months (range: 25–112 months). By the end of follow-up, no recurrence was observed, and all patients remained alive and healthy.

Retroperitoneal unicentric Castleman disease is rare and lacks specific clinical manifestations. Complete surgical resection is the optimal treatment, and patients exhibit excellent long-term prognosis upon follow-up.