FSH: Fiona Stanley Hospital, Murdoch, Australia.
BMC Urol. 2023 Aug 12;23(1):136. doi: 10.1186/s12894-023-01304-8.
Increased usage of cross sectional imaging for a variety of indications, in particular CT imaging, has led to an increased detection of renal and ureteric masses. Benign ureteric masses are rare, with 95% of identified tumours consisting of transitional cell carcinoma (TCC). IgG4-related disease is a recognised clinical systemic autoimmune, inflammatory condition with a propensity for multi-organ manifestation. Nephritis and pseudo-tumour formation can occur when kidneys are involved. Ureteric involvement is more rare.
Forty nine-year-old Korean male was found to have an incidental invasive renal pelvis mass during investigation for chronic back pain and fatigue. Appearance of the tumour was consistent with an invasive malignancy, and consensus from multidisciplinary meeting was to have the tumour removed. Procedure involved a prolonged open surgery with reconstruction of contralateral renal blood supply and was complicated by a long recovery process. Final histopathology confirmed IgG4 renal pseudo tumour diagnosis.
IgG4-related disease is a rare but potentially morbid disease that can mimic various cancers, including lung, pancreas and renal malignancies. A high index of suspicion is required to accurately diagnose this condition, through a targeted history taking, examination and investigation which should include biopsies. Failing to do so may result in unnecessary procedures being performed and exposing a patient to its associated risks.
由于各种适应症（特别是 CT 成像）中横截面成像的使用增加，导致肾脏和输尿管肿块的检出率增加。良性输尿管肿块很少见，95%的已识别肿瘤由移行细胞癌（TCC）组成。IgG4 相关疾病是一种公认的临床全身性自身免疫性炎症性疾病，易发生多器官表现。当肾脏受累时，会发生肾炎和假性肿瘤形成。输尿管受累更为罕见。
一名 49 岁的韩国男性因慢性背痛和疲劳接受检查时发现偶然的侵袭性肾盂肿块。肿瘤的表现与侵袭性恶性肿瘤一致，多学科会议的共识是切除肿瘤。该过程涉及长时间的开放式手术，对侧肾血供重建，并伴有长时间的恢复过程。最终的组织病理学证实了 IgG4 肾假性肿瘤的诊断。
IgG4 相关疾病是一种罕见但潜在病态的疾病，可模仿各种癌症，包括肺癌、胰腺癌和肾癌。需要高度怀疑才能通过有针对性的病史采集、检查和调查（包括活检）准确诊断这种疾病。如果不这样做，可能会导致不必要的手术，并使患者面临其相关风险。
