Intracranial Castleman's Disease Mimicking Dural-based Pathologies: A Case Report.

BACKGROUND

Castleman disease (CD) is a rare lymphoproliferative disorder, with intracranial involvement being exceedingly rare. Unicentric Castleman disease (UCD) is typically benign and localized, but its presentation can mimic other intracranial pathologies, complicating diagnosis.

CASE DESCRIPTION: We reported a 52-year-old woman who presented with progressive headaches and language disturbances. Imaging, including MRI and CT, revealed an extra-axial left frontotemporal lesion initially diagnosed as an en plaque meningioma. Surgical resection of the lesion was performed. Histopathological examination revealed UCD with plasma cell predominance, characterized by lymphoid hyperplasia and concentric germinal centers. Immunohistochemical staining confirmed the diagnosis, with positive markers including CD20, CD3, and CD16.

CONCLUSION

Intracranial UCD is a rare and challenging differential diagnosis for extra-axial lesions, often resembling meningiomas. Accurate diagnosis requires a combination of imaging and histopathology, with immunohistochemistry playing a crucial role. Complete surgical resection is the optimal treatment for localized UCD.