Intra-abdominal mass and iron deficiency anemia in a 15-year-old boy: Case report and literature review

Castleman's disease is rare lymphoproliferative disorder that typically presents as a mediastinal mass, although 10% of cases may be intra-abdominal. Given its rarity, diagnosis is often delayed until other pathology has been ruled out. We present the case of a 15-year-old boy with a one-year history of progressive fatigue, failure to thrive, and severe iron resistant, iron deficiency anemia. Extensive work-up revealed an intra-abdominal mass. At laparotomy, a discrete lymphoid-appearing mass was found at the base of the mesentery. Excision led to rapid and complete resolution of his symptoms, including resolution of anemia. Pathology demonstrated Castleman's disease of the hyaline vascular subtype. Increased awareness of this entity and its association with severe iron deficiency anemia though the overproduction of IL-6 may allow earlier detection and treatment.