title: IgG4-related paratesticular pseudotumor in a patient with autoimmune pancreatitis and retroperitoneal fibrosis: an extrapancreatic manifestation of IgG4-related disease.
abstract: In this report, we describe the first case of a patient with an IgG4-related paratesticular pseudotumor. He had histologically proven autoimmune pancreatitis, then later developed a scrotal mass. The orchiectomy specimen revealed that this was a paratesticular pseudotumor with histopathologic and immunohistochemistry findings characteristic of IgG4-related disease. Paratesticular pseudotumors are uncommon causes of intrascrotal masses and have an unexplained pathogenesis. A variety of genitourinary manifestations of IgG4-related disease including IgG4-related tubulointerstitial nephritis, IgG4-related ureteral pseudotumors, and IgG4-related prostatitis has been previously reported. The current case highlights the need to have a high index of suspicion for IgG4-tissue infiltration in patients with known autoimmune pancreatitis, particularly those with a pseudotumor.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN 55905, USA.
authors.forename: Phil A
authors.initials: PA
authors.lastname: Hart
authors.forename: Ann M
authors.initials: AM
authors.lastname: Moyer
authors.forename: Eunhee S
authors.initials: ES
authors.lastname: Yi
authors.forename: Marie C
authors.initials: MC
authors.lastname: Hogan
authors.forename: Randall K
authors.initials: RK
authors.lastname: Pearson
authors.forename: Suresh T
authors.initials: ST
authors.lastname: Chari
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006104:Granuloma, Plasma Cell / Q000150:complications / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D009919:Orchiectomy; D010195:Pancreatitis / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use; D012185:Retroperitoneal Fibrosis / Q000150:complications / Q000276:immunology / Q000473:pathology*; D013733:Testicular Diseases / Q000150:complications / Q000276:immunology / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007074:Immunoglobulin G; D011241:Prednisone