Endoscopic-Assisted Excision of Parotid Castleman Disease in Pediatric Patients: A Case Series of Three Patients and a Literature Review

BACKGROUND Castleman disease (CD) is a rare lymphoproliferative disorder, and parotid involvement in children is exceptionally uncommon. It is typically classified as unicentric (UCD) or multicentric; the hyaline vascular (HV) type is most prevalent. Surgical excision remains the standard curative treatment for UCD. CASE REPORT This study synthesizes recent advances in endoscopic-assisted excision of parotid CD among pediatric patients. We describe 3 pediatric patients (ages 2, 7, and 10 years) who presented with asymptomatic parotid masses, all initially misdiagnosed. Each patient underwent endoscopic-assisted resection via retroauricular or postauricular incisions to minimize visible scarring. Histopathologic evaluation confirmed HV-type UCD in all cases. No facial nerve injury occurred; all patients achieved uneventful recovery with no recurrence and excellent cosmetic results. A literature review of PubMed and Web of Science covering January 2000 to July 2025 identified 32 cases of parotid CD from 27 articles. HV-type UCD was predominant; 13 (40.6%) were pediatric cases, typically involving slow-growing, asymptomatic masses. Surgical excision was curative; conventional approaches often resulted in visible scars. Endoscopic-assisted techniques improved visualization, protected the facial nerve, and achieved superior cosmetic outcomes. Although infrequently reported in pediatric patients, our findings demonstrate that endoscopic-assisted parotidectomy is feasible and safe in this population. CONCLUSIONS Early diagnosis and prompt surgical excision are essential for pediatric parotid CD. HV-type UCD is most common, and prognosis is excellent after complete resection. Endoscopic-assisted surgery provides an effective, minimally invasive, and cosmetically favorable option for pediatric patients. Long-term follow-up remains important to detect rare recurrence or malignant transformation.