Anesthesia management for surgical excision in patients with Rosai-Dorfman disease involving multiple organs throughout the body: a case report and literature review

BACKGROUND: Rosai-Dorfman disease (RDD) is a rare, benign multisystem histiocytic disorder. Cases involving multiple organs and requiring multiple surgeries are uncommon, resulting in limited clinical experience. CASE PRESENTATION: We report the case of a 62-year-old male with RDD involving multiple sites, including the nasopharynx, palate, neck, craniocervical junction, anterior brainstem, thoracic spine (T4–T7) within the spinal canal, and mediastinum. The patient was admitted due to ureteral compression by a pelvic RDD mass, causing urinary obstruction and necessitating surgical intervention. Airway management posed a major anesthetic challenge, as the nasal cavity, palate, pharynx, and larynx were all affected by the disease, making tracheal intubation under general anesthesia particularly difficult. CONCLUSIONS: A personalized, multidisciplinary approach—incorporating thorough preoperative evaluation, advanced imaging, and flexible intubation strategies—is essential for managing RDD patients with complex multi-organ involvement. Preparation for potential airway compromise or edema is critical to achieving safe perioperative outcomes. TRIAL REGISTRATION: Not applicable.