A Rare Case of Pheochromocytoma Presenting as Cervical Mass

Angiofollicular lymph node hyperplasia (ALNH) or Castleman’s disease (CD) is an unusual benign non-neoplastic lymphoproliferative disease. CD can present as a localised mass. In this paper a rare case of Castleman’s disease in a 34 years old woman with a cervical mass is presented.

A 34 years-old woman presented in July 2018 with a painful mass neck that was appeared in 2010 referred to pain clinic because of painful cervical mass. She presented to a general surgeon. Primary par clinic assessments such as ultrasound and CT scan revealed that the mass is not cancerous and surgery is dangerous because the sites of the mass. During the last year size of the mass increased rapidly and, patient decided to get rid of the mass because of pain and bad view in her neck. She had no associated symptoms with the mass such as weight loss, fever, excessive sweating during 7 years ago. On physical examination we found a 2/5 cm tendered bulged mass which was stacked to left sternocleidomastoid muscle. The routine laboratory tests was normal. Patient underwent ultrasound and CT scan again. Ultrasound demonstrated a 60mm*27mm*40 mm well defined homogenous hypo echoic mass in left posterior cervical triangle. The CT-Scan demonstrated a 60mm*30mm *42 mm well defined homogenous oval mass isodense to sternocleidomastoid muscle in left posterior cervical triangle. Differential diagnosis was posterior cervical schwanoma, carotid body tumor, lymphoma and reactive lymphadenopathy. Patient underwent surgery successfully. The pathology report demonstrated the diagnosis is Castleman’s disease.

Castleman’ disease is one of the differential diagnoses of masses in the neck. Histopathlogically findings is needed to achieving a definitive diagnosis. Some types of CD are associated with malignancies such as nonhodgkin lymphoma, Kaposi’s sarcoma, follicular dendritic cell sarcoma, or carcinoma.