IgG4 disease as a differential diagnosis of head and neck squamous cell carcinoma

Aim To highlight the need to include IgG4 disease in the differential diagnosis of head and neck squamous cell carcinoma (SCC). Method We will present two cases which recently presented to the Maxillofacial Department at the RVI hospital, Newcastle, UK. One had a large palatal ulceration and one had...

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Bibliographic Details
Published in:Oral surgery 2022-02, Vol.15 (1), p.88-92
Main Authors: Swansbury, Andrew, Pilkington, Richard J. J., Kennedy, Matthew, Adams, James R.
Format: Article
Language:English
Subjects:
Biopsy
carcinoma
Differential diagnosis
Head & neck cancer
Head and neck carcinoma
IgG4
Immunoglobulin G
Immunosuppressive agents
Maxillofacial
Patients
Prednisolone
Quality of life
Rheumatology
Rituximab
Squamous cell carcinoma
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Summary:Aim To highlight the need to include IgG4 disease in the differential diagnosis of head and neck squamous cell carcinoma (SCC). Method We will present two cases which recently presented to the Maxillofacial Department at the RVI hospital, Newcastle, UK. One had a large palatal ulceration and one had a soft tissue mass on the orbital floor with extensions into the maxillary antrum. Results Both cases had clinical and radiographic features indicative of SCC, however, following biopsy a definitive diagnosis of IgG4 disease was made. The patients were treated successfully medically via MDT (Multidisciplinary Team) with rheumatology. This involved the use of immunosuppressants including Prednisolone and Rituximab. Conclusions Treatment for head/neck SCC typically involves large resections with significant impacts upon a patient's quality of life. Therefore, it is important that alternative diagnosis is considered and excluded. We hope these cases show that IgG4 disease should be on this list.
ISSN:1752-2471
1752-248X
DOI:10.1111/ors.12605