Published online Sep 15, 2017. doi: 10.4251/wjgo.v9.i9.397
Peer-review started: February 9, 2017
First decision: March 22, 2017
Revised: April 6, 2017
Accepted: May 18, 2017
Article in press: May 19, 2017
Published online: September 15, 2017
Castleman’s disease (CD) is an uncommon benign lymphoproliferative disorder of unknown etiology. A rare case of cervical CD diagnosed at lymph node dissection for esophageal carcinoma is reported. An esophageal tumor was identified in a 67-year-old man during a follow-up examination after surgery for oral carcinoma. Esophagoscopy revealed a type 1 tumor in the cervical esophagus. Histology of esophagoscopic biopsies indicated squamous cell carcinoma. Contrast-enhanced computed tomography revealed swollen lymph nodes of the right cervical region. No distant metastasis was detected. Esophageal carcinoma, T2N2M0, Stage IIIA was diagnosed. Neoadjuvant chemotherapy was recommended, but the patient rejected the chemotherapy. The patient underwent laparoscopic-assisted transhiatal esophagectomy. The histopathological diagnosis was moderately differentiated squamous cell carcinoma with pT1bN0M0, Stage IA. On histology, the swollen lymph nodes of the right cervical region revealed CD. The patient’s postoperative course was relatively good.
Core tip: The association of Castleman’s disease (CD) with epithelial malignancy is rare. To the best of our knowledge, the present case is the first report of a synchronous esophageal carcinoma and cervical CD. In the present case, we clinically diagnosed esophageal carcinoma with right cervical lymph nodes metastasis, T2N2M0, Stage IIIA preoperatively, but the stage was revised to pT1bN0M0, Stage IA on pathological diagnosis. Via histology, the swollen lymph nodes of the right cervical region revealed CD. This case demonstrates that cervical CD is rarely associated with an esophageal carcinoma and can clinically mimic nodal metastasis.