Castleman disease masquerading as a paraganglioma showing uptake on DOTATATE PET

A man in his 50s presented with shortness of breath and was found to have a large paracaval mass, which on further evaluation with CT, showed a large heterogeneously enhancing mass lesion adjacent to right renal hilum. His 24-hour urinary metanephrines and nor-metanephrines were normal. In view of location and features on CT, paraganglioma was considered as a possibility. A Ga-68-DOTATATE positron emission tomography/CT demonstrated avidity in the lesion with maximum standardised uptake value of 16.5. He underwent right laparoscopic converted to open mass excision along with nephrectomy. Histopathological examination was suggestive of hyaline vascular Castleman disease.

Automated summary

A man in his 50s presented with shortness of breath and was found to have a large paracaval mass, which was further evaluated using CT scan and showed a large heterogeneously enhancing mass lesion adjacent to the right renal hilum. Ga-68-DOTATATE positron emission tomography/CT revealed avidity in the lesion with a maximum standardised uptake value of 16.5. Surgical excision of the mass with nephrectomy was performed and histopathological examination confirmed the diagnosis of hyaline vascular Castleman disease.