Unicentric Castleman disease of plasma cell type in the adrenal region: a case report and literature review.

BACKGROUND: Castleman disease (CD) comprises a heterogeneous group of lymphoproliferative disorders. Unicentric CD (UCD) involving the adrenal region is uncommon and poses diagnostic challenges because it can resemble adrenal neoplasms. CASE PRESENTATION: A 37-year-old female presented with a 10-year history of intermittent hyperhidrosis and facial flushing, and a one-month history of right chest and abdominal pain. Imaging revealed a 53 mm × 42 mm heterogeneous mass in the left adrenal region with calcification and marked enhancement. Endocrine evaluation showed no hormonal hypersecretion. The patient underwent laparoscopic tumor resection. Histopathology and immunohistochemistry confirmed plasma cell type UCD, with HHV-8 negative on both serology and immunohistochemistry. Postoperative recovery was uneventful. Postoperative PET/CT and PET/MRI showed no evidence of residual or recurrent disease. At the two-year follow-up, the patient remained asymptomatic with no evidence of recurrence. CONCLUSION: Adrenal-region UCD is an uncommon entity that can mimic nonfunctional adrenal tumors. Complete surgical excision is curative. This case highlights the importance of including UCD in the differential diagnosis of well-defined adrenal masses without endocrine abnormalities.