title: Invasive cervical cancer accompanied by IgG4-related disease.
abstract: IgG4-related disease (IgG4-RD) is a systemic disease that affects multiple organs and generates nodules or thickening. Discriminating these diseases from malignancy is important because glucocorticoid treatment is effective for patients with IgG4-RD. Coexistence of IgG4-RD with various malignant diseases has been reported, but there are few reports with regard to gynecologic malignant diseases. We encountered a case of invasive cervical cancer stage IIB accompanied by IgG4-RD. The patient was a 46-year-old woman. On pelvic magnetic resonance imaging, fluorodeoxyglucose-positron emission tomography and computed tomography, systemic multiple lymph node swelling was seen, including in the neck and the mediastinum in addition to uterine cervix. Diagnosis (and hence, appropriate treatment choice) was achieved on pathology of the submandibular gland and uterus, and analysis of serum IgG4. IgG4-RD should be suspected in patients presenting with malignancy and unusual multiple lymph node swelling.
authors.affiliation: Department of Gynecology, Shiga Medical Center for Adults, Moriyama City, Shiga, Japan. rin0617@kuhp.kyoto-u.ac.jp.
authors.forename: Rin
authors.initials: R
authors.lastname: Mizuno
authors.affiliation: Department of Gynecology and Obstetrics, Otsu Municipal Hospital, Otsu City, Shiga, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yamanishi
authors.affiliation: Department of Gynecology, Shiga Medical Center for Adults, Moriyama City, Shiga, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Uda
authors.affiliation: Department of Pathology, Shiga Medical Center for Adults, Moriyama City, Shiga, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Terashima
authors.affiliation: Shiga Medical Center Research Institute, Moriyama City, Shiga, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Gynecology, Shiga Medical Center for Adults, Moriyama City, Shiga, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Higuchi
mesh_terms: D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D060787:Neoplasm Grading; D000072078:Positron Emission Tomography Computed Tomography; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D007074:Immunoglobulin G
keywords: IgG4-related disease; cervical cancer; fluorodeoxyglucose-positron emission tomography; para-aortic lymph node swelling; submandibular gland