The case of a 38-year-old man with renal colic due to compression by an abdominopelvic mass is reported. Histologic examination of the mass led to the diagnosis of giant lymph node hyperplasia or Castleman disease. Surgical removal of the lesion ensured complete recovery with no recurrence after 32 months follow up. Giant lymph node hyperplasia usually develops in the mediastinum, but superficial and abdominopelvic forms are seen occasionally. Pathogenic hypotheses are discussed. Outcome is usually favorable following surgical excision but rare multifocal forms with a potentially poor prognosis have been reported.