The authors present the first case report of Castleman disease with a unique presentation. A large tumor grew alongside the spine through the neural foramen (opening for nerves and blood vessels). It was located in the thoracic spine. MRI and clinic results led doctors to think it was a nerve sheath tumor.
Castleman disease is named after Dr. Castleman who first described the condition in 1956. It is a rare type of tumor made up of plasma cells in the lymph fluid from the immune system. The cause is unknown. Very rarely (only 13 cases have ever been reported), Castleman disease affects the central nervous system. Only four cases of the spine have ever been reported.
In this case, a 19-year old woman went to the doctor because of a cough, nausea, and vomiting. Chest X-ray showed a large mass along the right side of her spine. MRI pinpointed it at the T7-8 level extending into the neural foramen on the right side.
Surgery to remove the tumor was done. A small piece of tissue was taken for pathologic exam. That’s when they found out what it was. They were unable to remove it, so she had radiation treatment instead. Radiotherapy was successful. One year later, the patient was symptom- and tumor free.