Unicentric Castleman disease in intraparotid lymph node: a case report.

Abstract

Background: Castleman disease (CD) is a rare lymphoproliferative disorder characterized by non-neoplastic lymph node hyperplasia. Unicentric Castleman disease (UCD), the most common clinical form, typically presents as a solitary, asymptomatic mass. Involvement of intraparotid lymph nodes is rare and often mimics salivary gland neoplasms, complicating preoperative diagnosis.

Case presentation: A 35-year-old female presented with a painless, enlarging mass in the left parotid region. Contrast-enhanced CT revealed a well-demarcated, homogeneously enhancing mass with additional smaller lesions in adjacent lymph node regions. A conservative excisional approach was performed with preservation of the facial nerve. Histopathological evaluation confirmed the hyaline-vascular variant of UCD. Postoperative follow-up showed spontaneous regression of adjacent lymphadenopathy and resolution of transient facial nerve palsy.

Conclusion: CD should be considered in the differential diagnosis of encapsulated parotid masses with associated lymphadenopathy. Recognizing its clinical and radiologic features may facilitate accurate diagnosis and prevent overtreatment. Complete surgical excision is curative in most UCD cases.