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<p>In the head and neck region, IgG4-related disease (IgG4-RD) usually affects the lacrimal and salivary glands. Sinonasal presentation is rare and masquerades as malignancy, infection and inflammation. A 47-year-old male presented with right-sided dental pain and cheek swelling since four months. Examination revealed a diffuse right maxillary swelling and tenderness. MRI brain and paranasal sinuses with contrast showed an expansile lesion involving the right maxillary sinus, extending into the premaxilla, orbit and lateral wall of nasal cavity. FESS plus Caldwell Luc procedure was performed and tissue was sent for histopathology. Histopathological features and elevated serum IgG4 levels clinched a definite diagnosis of IgG4-RD. Patient was started on oral prednisolone and 7-month follow up was uneventful. A high index of suspicion is required to diagnose sinonasal IgG4-RD, particularly in patients with symptoms not responding to standard treatment. Surgical resection and oral prednisolone form the pillars of management.</p>

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IgG4-Related Disease: A Sinonasal Masquerade

  • 期刊论文

  • 发表日期：

    2026年3月28日

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  • Manishaa E V,
  • Akilan Alagesan,
  • Bathi Reddy,
  • Vidya Manur Narasimhamurthy

摘要

In the head and neck region, IgG4-related disease (IgG4-RD) usually affects the lacrimal and salivary glands. Sinonasal presentation is rare and masquerades as malignancy, infection and inflammation. A 47-year-old male presented with right-sided dental pain and cheek swelling since four months. Examination revealed a diffuse right maxillary swelling and tenderness. MRI brain and paranasal sinuses with contrast showed an expansile lesion involving the right maxillary sinus, extending into the premaxilla, orbit and lateral wall of nasal cavity. FESS plus Caldwell Luc procedure was performed and tissue was sent for histopathology. Histopathological features and elevated serum IgG4 levels clinched a definite diagnosis of IgG4-RD. Patient was started on oral prednisolone and 7-month follow up was uneventful. A high index of suspicion is required to diagnose sinonasal IgG4-RD, particularly in patients with symptoms not responding to standard treatment. Surgical resection and oral prednisolone form the pillars of management.