title: Immunoglobulin G4-related disease presenting as bilateral ovarian masses and mimicking advanced ovarian cancer.
abstract: Immunoglobulin G4-related disease (IgG4-RD) is characterized by extensive infiltration of IgG4(+) plasma cells and fibrosis in various organs. However, the involvement of the ovary in IgG4-RD has never been reported. A 59-year-old woman presented with urinary retention. Magnetic resonance imaging and computed tomography revealed a huge multinodular pelvic mass and common iliac/para-aortic lymph node swelling. A laparotomy was performed under the suspicion of advanced ovarian cancer, and the pelvic mass was identified as ovary in origin. Histopathology of the excised tumor revealed massive lymphoplasmacytic infiltration (>90% were IgG4(+) plasma cells), storiform fibrosis, and obliterative phlebitis; thus leading to a diagnosis of IgG4-RD. We conclude that IgG4-RD can present as a bilateral ovarian mass along with lymphadenopathy, therefore mimicking ovarian cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Maruyama
authors.affiliation: Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Taga
authors.affiliation: Department of Obstetrics and Gynecology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Emoto
authors.affiliation: Department of Pathology, Otsu Red Cross Hospital, Otsu, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shirase
authors.affiliation: Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
mesh_terms: D001327:Autoimmune Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D000072281:Lymphadenopathy / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010053:Ovary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010950:Plasma Cells / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007074:Immunoglobulin G
keywords: PET-CT; lymphadenopathy; primary biliary cirrhosis; storiform fibrosis