A case of abdominal mesenteric Castleman's disease with left renal cell carcinoma and stomach leiomyoma.

A rare case of abdominal mesenteric Castleman's disease with left renal cell carcinoma and stomach leiomyoma is reported. A 57 years old male patient was transferred to our hospital for investigation of a left kidney tumor. Physical examination and routine laboratory tests were normal. Multi mode imaging by 64-slices spiral computed tomography (CT) scan, the enhanced CT scan and the fluorine-18-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) scan were applied. Computed tomography showed a 5.4cm×5.2cm mass in the abdomen. The radioactive distribution of the mass was high SUVmax about 4.5. Furthemore, a soft tissue mass, about 3.9cm×3.0cm, was detected in the left kidney, with significantly inhomogeneous enhancement in the arterial phase of the CT scan, while contrast agent CT showed activity in the venous phase. The radioactive distribution of this mass was slightly concentrated and its SUVmax was about 3.2. With the stomach filled with water , an oval shaped and slightly lobulated soft tissue mass was also observed in the cardia, with a size about 4.6cm×3.0cm. Computed tomography showed mild enhancement of radioactively in the arterial phase and delayed enhancement in the venous phase. The radioactive distribution of the mass was diffused and SUVmax was about 4.7. CONCLUSION The patient was operated and pathology showed: a) A mesenteric mass and abdominal lymph nodes with cells of the hyaline vascular type of Castleman's disease. b) Renal clear cells carcinoma of the left kidney and c) Spindle cells leiomyoma tumor in the gastric cardia. Three tumors in the same patient are extremely rare.