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Immunoglobulin-G4 related mastitis: A case report
Affiliation:1. Department of General Surgery (Monash Health), 135-145 David Street, Dandenong, VIC 3175, Australia;2. Lake Imaging, St John of God Hospital, Geelong, VIC, Australia;3. Department of Breast Surgery (Monash Health), Moorabbin Hospital, 823-865 Centre Rd, Bentleigh East, VIC 3165, Australia
Abstract:IntroductionIgG4-related mastitis (IgG4-RM) is exceedingly rare with only ten cases reported in the literature to date. Organs that are affected with IgG4-related disease (IgG4-RD) all share the same histopathological hallmarks consisting of dense lymphocytic infiltration, storiform fibrosis and obliterative phlebitis.Presentation of caseThis case report highlights a case of IgG4-RM found incidentally in a 52-year-old woman during a routine breast screen and it explores the current literature about IgG4-RM and IgG4-RD.DiscussionIgG4-RM and IgG4-RD, in general, is a new entity in the field of medicine and its aetiology is not well understood. In the literature, IgG4-RM often presents as a painless palpable breast lump in isolation or with other systemic manifestations. IgG4-RM is considered benign and has excellent prognosis post-conservative treatment with steroid or surgical excision.ConclusionIgG4-RM is diagnosed exclusively on histological analysis. It is hard to distinguish IgG4-RD from malignant breast lesions purely on clinical examination and imaging studies. Increasing awareness of this condition among clinicians will assist them in managing patients better. Extensive whole body imaging is not recommended unless symptomatic.
Keywords:Immunoglobulin-G4  Sclerosing mastitis  Granulomatous disease  Breast  Autoimmune  Case report
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