輸尿管癌的模仿者：輸尿管IgG4疾病之病例報告

The Mimicker of ureteral cancer: A Case Report of Ureteral IgG4-Related Disease

劉永浩、鄭苑伶、丁慧恭、曹智惟、蒙恩、孫光煥

國防醫學院三軍總醫院外科部泌尿外科

Yung-Hao Liu, Yuan-Ling Cheng, Hui-Kung Ting, Chih-Wei Tsao, En Meng, Guang-Huan Sun

Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Introduction

    IgG4-related disease (IgG4-RD) is a multi-organ, inflammatory condition, characterized by tissue infiltration of IgG4-positive plasma cells and associated fibrosis. It is uncommon in the genitourinary system and primarily affects the kidneys, making ureteral involvement particularly rare.

Case presentation

    Here, we describe a 62-year-old male present with bilateral upper eyelid swelling, chronic cough, and hydronephrosis. Initial evaluation includes an abdominal CT, MRI, and ureteral biopsies, though malignancy could not be definitively excluded. Surprisingly, IgG4-related disease (IgG4-RD) was diagnosed through ophthalmologic evaluation, with lacrimal gland pathology confirming dense IgG4+ plasma cell infiltrates and fibrosis.

Conclusion

    This case highlights the need to consider systemic diseases like IgG4-RD when facing ambiguous ureteral findings, as overlooking systemic conditions may lead to unnecessary surgical interventions. A thorough diagnostic approach is crucial in preventing misdiagnosis or unwarranted procedures, such as nephroureterectomy.