Lin Hsin-Chia Angela, Lee Kam-Fai, Huang Tzu Hao
Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
World J Clin Cases. 2024 Jan 6;12(1):176-179. doi: 10.12998/wjcc.v12.i1.176.
Gastric IgG4-related disease (IgG4-RD) is rarely encountered in clinical practice, and especially more so among pediatric patients. To our knowledge, this is the first report of IgG4-RD presenting as a calcifying gastric mass in a child. We describe how this entity was difficult to differentiate from a gastrointestinal stromal tumor (GIST) imaging-based approaches. Therefore, this case highlights the importance of considering IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection, especially to distinguish it from malignancy to avoid unnecessary surgery.
The patient suffered from epigastric pain for several days. Panendoscopy and computed tomography scan revealed a submucosal tumor. Differential diagnoses included GIST, leiomyoma, teratoma, and mucinous adenocarcinoma. However, laparoscopic proximal gastrectomy allowed for the definitive diagnosis of IgG4-related stomach disease.
We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.
胃IgG4相关疾病（IgG4-RD）在临床实践中很少见，在儿科患者中尤其如此。据我们所知，这是首例儿童IgG4-RD表现为钙化性胃肿块的报道。我们描述了基于影像学方法该实体如何难以与胃肠道间质瘤（GIST）相鉴别。因此，该病例凸显了在进行手术切除前，在胃肿瘤的鉴别诊断中考虑IgG4-RD的重要性，尤其是将其与恶性肿瘤区分开来以避免不必要的手术。
患者上腹部疼痛数天。全内镜检查和计算机断层扫描显示一个黏膜下肿瘤。鉴别诊断包括GIST、平滑肌瘤、畸胎瘤和黏液腺癌。然而，腹腔镜近端胃切除术最终确诊为IgG4相关胃病。
我们强调在进行手术切除前，在胃黏膜下肿瘤的鉴别诊断中考虑IgG4-RD的重要性。
