title: Immunoglobulin G4-related sclerosing cholecystitis presenting as gallbladder cancer: a case report.
abstract: Immunoglobulin G4 (IgG4)-related sclerosing disease is a systemic inflammatory syndrome, and an understanding of its characteristics is currently evolving. IgG4-related cholecystitis is a manifestation of IgG4-related sclerosing disease in the gallbladder. This case report describes the clinical, radiographic, and histopathological findings in a young male patient who presented with a synchronous mass in the gallbladder. Serum levels of IgG4 and the IgG4/IgG ratio were normal, and there was no associated autoimmune pancreatitis. Therefore, establishing a preoperative diagnosis of IgG4-related cholecystitis was very difficult, and a differential diagnosis of gallbladder cancer infiltrating the liver was suggested. Postoperative histopathological examination established a diagnosis of IgG4-related cholecystitis definitively. A preoperative diagnosis of IgG4-related cholecystitis, although possible, would have been highly challenging in this case. It is difficult to establish whether surgical intervention is necessary in IgG4-related cholecystitis. Because malignant tumors are frequently suspected with this clinical presentation, surgical intervention should be undertaken only after due deliberation.
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. kodaiyy@hotmail.co.jp.
authors.forename: Kodai
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. h-ito@sth-medical.co.jp.
authors.forename: Hideto
authors.initials: H
authors.lastname: Ito
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. t-katsube@sth-medical.co.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Katsube
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. a-tsuboi@sth-medical.co.jp.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Tsuboi
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. m-hashimoto@sth-medical.co.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hashimoto
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. e-oota@sth-medical.co.jp.
authors.forename: Emi
authors.initials: E
authors.lastname: Ota
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. k-mita@sth-medical.co.jp.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Mita
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. h-asakawa@sth-medical.co.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Asakawa
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. t-hayashi@sth-medical.co.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Surgery, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. k-fujino@sth-medical.co.jp.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fujino
authors.affiliation: Department of Pathology, New Tokyo Hospital, 1271 Wanagaya, Matsudo City, Chiba, Japan. s-okamoto@seikei-kai.or.jp.
authors.forename: Sigeru
authors.initials: S
authors.lastname: Okamoto
keywords: Gallbladder cancer; IgG4-related cholecystitis; IgG4-related sclerosing disease