Multiple Pseudotumors in IgG4-Associated Multifocal Systemic Fibrosis
Authors: Hans J.J. van der Vliet, Roos M. Perenboom
Journal: Annals of Internal Medicine (2004)

Letters7 December 2004Multiple Pseudotumors in IgG4-Associated Multifocal Systemic FibrosisHans J.J. van der Vliet, MD, PhD and Roos M. Perenboom, MD, PhDHans J.J. van der Vliet, MD, PhDFrom Vrije Universiteit Medical Center, 1081 HV Amsterdam, the Netherlands. and Roos M. Perenboom, MD, PhDFrom Vrije Universiteit Medical Center, 1081 HV Amsterdam, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-11-200412070-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: The work-up of patients with multiple tumors frequently provides evidence of metastatic disease.Objective: We present the case of a patient with tumors in the brain, lung, and submandibular region after a previous pancreatic tumor who received a diagnosis of multifocal systemic fibrosis.Case Report: A 66-year-old woman presented with a 2-week history of nausea, headache, and fever. Three years earlier, a Whipple procedure was performed for a pancreatic tumor. Pathologic examination had shown focal pancreatitis and fibrosis, but no malignant disease. At the current presentation, bilateral firm submandibular masses were noted. Cytologic examination of one ...References1. Hamano H, Kawa S, Horiuchi A, Unno H, Furuya N, Akamatsu T, et al. High serum IgG4 concentrations in patients with sclerosing pancreatitis. N Engl J Med. 2001;344:732-8. [PMID: 11236777] CrossrefMedlineGoogle Scholar2. Chen RY, Adams DB. IgG4 levels in non-Japanese patients with autoimmune sclerosing pancreatitis [Letter]. N Engl J Med. 2002;346:1919. [PMID: 12063386] CrossrefMedlineGoogle Scholar3. Hamano H, Kawa S, Ochi Y, Unno H, Shiba N, Wajiki M, et al. Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis. Lancet. 2002;359:1403-4. [PMID: 11978339] CrossrefMedlineGoogle Scholar4. van Bommel EF. Retroperitoneal fibrosis. Neth J Med. 2002;60:231-42. [PMID: 12365466] MedlineGoogle Scholar5. Comings DE, Skubi KB, Van Eyes J, Motulsky AG. Familial multifocal fibrosclerosis. Findings suggesting that retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Riedel's thyroiditis, and pseudotumor of the orbit may be different manifestations of a single disease. Ann Intern Med. 1967;66:884-92. [PMID: 6025229] LinkGoogle Scholar6. Kamisawa T, Funata N, Hayashi Y, Tsuruta K, Okamoto A, Amemiya K, et al. Close relationship between autoimmune pancreatitis and multifocal fibrosclerosis. Gut. 2003;52:683-7. [PMID: 12692053] CrossrefMedlineGoogle Scholar7. Kamisawa T, Funata N, Hayashi Y, Eishi Y, Koike M, Tsuruta K, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol. 2003;38:982-4. [PMID: 14614606] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Vrije Universiteit Medical Center, 1081 HV Amsterdam, the Netherlands. 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