Journal of Clinical Otolaryngology Head and Neck Surgery (임상이비인후과)

The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery (대한이비인후과학회 부산,울산,경남 지부회)
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Immunoglobulin G4-Related Disease Masquerading Anaplastic Thyroid Carcinoma

  • Kim, Ji-a (Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital) ;
  • Jo, Min-gyu (Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Seok-hyun (Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, Young Geum (Department of Pathology, Pusan National University Hospital) ;
  • Cha, Wonjae (Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Pusan National University Hospital)
  • ;
  • ;
  • ;
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  • 차원재 (부산대학교 의과대학 부산대학교병원 이비인후과학교실)
  • Received : 2018.09.17
  • Accepted : 2018.11.08
  • Published : 2018.12.30

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Abstract

Immunoglobulin G4-related disease (IgG4RD) is a chronic inflammatory condition characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, as well as varying degrees of fibrosis. We report a case of a 70-year-old man with a rapid-growing cervical mass for several months. Computed tomography and positron emission tomography showed a huge, ill-defined mass involving left thyroid lobe and encasing the common carotid artery, which was clinically and radiologically suspicious for anaplastic thyroid carcinoma. Ultrasonography-guided core needle biopsy was performed and histopathology examination revealed to be consistent with IgG4RD, and the IgG4/IgG ratio was 0.6. After oral corticosteroid was administered, the mass was dramatically resolved. Because IgG4RD often presents as a single localized and infiltrated mass lesion, it can be confused and misdiagnosed as a malignancy. Thus, clinicians should consider IgG4RD as a differential diagnosis in a rapid-growing neck mass to prevent unnecessary and excessive treatments.

Keywords

Acknowledgement

Supported by : Pusan National University Hospital

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