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KMID : 0390220180290020301
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2018 Volume.29 No. 2 p.301 ~ p.306
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Immunoglobulin G4-Related Disease Masquerading Anaplastic Thyroid Carcinoma
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Kim Ji-A
Jo Min-Gyu
Kim Seok-Hyun
Kim Young-Geum
Cha Won-Jae
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Abstract
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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.
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KEYWORD
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Immunoglobulin G4-related disease, Anaplastic thyroid carcinoma, Inflammatory tumor, Neck mass
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