Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 176-179
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.176
Gastric IgG4-related disease mimicking a gastrointestinal stromal tumor in a child: A case report
Hsin-Chia Angela Lin, Kam-Fai Lee, Tzu Hao Huang
Hsin-Chia Angela Lin, Tzu Hao Huang, Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
Kam-Fai Lee, Department of Anatomic Pathology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
Author contributions: Lin HCA drafted the manuscript and performed the data collection; Lee KF performed the data analysis and interpretation; Huang TH reviewed and revised the manuscript; all authors approved the final manuscript as submitted.
Informed consent statement: Consent was obtained from the patient for publication of their anonymized case and accompanying images.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tzu Hao Huang, MD, Surgeon, Surgical Oncologist, Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, No. 6 Sec. West Chia-Pu Road, Chiayi 613, Taiwan. tambobo8916@gmail.com
Received: September 24, 2023
Peer-review started: September 24, 2023
First decision: November 16, 2023
Revised: November 28, 2023
Accepted: December 20, 2023
Article in press: December 20, 2023
Published online: January 6, 2024
Processing time: 99 Days and 17.2 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

We emphasize the importance of considering IgG4-RD in the differential diagnosis of gastric submucosal tumors before performing surgical resection.

Keywords: IgG4-related disease; Gastrointestinal stromal tumor; Child; Pediatric; Case report

Core Tip: Gastric IgG4-related disease (IgG4-RD) is rarely encountered in clinical practice, especially among pediatric patients. To our knowledge, this is the first report of IgG4-RD presenting as a gastric calcifying mass in a child. This entity was difficult to differentiate from a gastrointestinal stromal tumor by imaging-based approaches. Therefore, it is important to consider IgG4-RD in the differential diagnosis of gastric tumor before performing surgical resection, especially to distinguish it from malignancy and avoid non-essential surgery.