Journal of Clinical Otolaryngology Head and Neck Surgery

The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery

J Clin Otolaryngol Head Neck Surg 2018; 29(2):301-306

pISSN: 1225-0244, eISSN: 2713-833X

DOI: https://doi.org/10.35420/jcohns.2018.29.2.301

증례

Immunoglobulin G4-Related Disease Masquerading Anaplastic Thyroid Carcinoma

Ji-a Kim¹, Min-gyu Jo¹, Seok-hyun Kim¹, Young Geum Kim², Wonjae Cha¹^,²^,^*

¹Department of Otorhinolaryngology-Head and Neck Surgery and Biomedical Research Institute, Busan, Korea

²Pathology, Pusan National University Hospital, Busan, Korea

^*교신저자: 차원재, 49241 부산광역시 서구 구덕로 179 부산대학교 의과대학 부산대학교병원 이비인후과학교실 전화: (051) 240-7336·전송 :(051) 246-8668 E-mail: chawonjae@gmail.com

© Copyright 2018 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Sep 17, 2018; Revised: Oct 30, 2018; Accepted: Nov 08, 2018

Published Online: May 31, 2020

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. (J Clinical Otolaryngol 2018;29:301-306)

Keywords: Immunoglobulin G4-related disease; Anaplastic thyroid carcinoma; Inflammatory tumor; Neck mass