Colon cancer and IgG4-related disease with orbital inflammation and bilateral optic perineuritis: A case report. Issue 39 (September 2018)

• Record Type: Journal Article
• Authors: Lemaitre, Stephanie; Esquerda, Gemma Mateu; Guardiola, Antoni Castro; Agustin, Jordi Teruel; Sanda, Nicolae; González-Candial, Miguel
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 39(2018)
• Publication Date: 2018-09
• Subjects: colon cancer -- IgG4-related disease -- optic perineuritis -- orbital inflammation -- paraneoplastic syndrome; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000012197
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition of unknown cause. Cancer might be related to the development of certain IgG4-RD but to date, little literature documents it. Patient concerns: A 78-year old man presented with unilateral proptosis responsive to steroids, initially attributed to nonspecific orbital inflammation. Diagnosis: Right hemicolectomy was performed because of a suspicious lesion which turned out to be tubulovillous adenoma on histological analysis. Eight months after the surgery, a mass infiltrating the mesentery was found and biopsy revealed IgG4-RD. Interventions: Both the orbital inflammation and abdominal mass infiltrating the mesentery were responsive to steroids and rituximab administered to treat IgG4-RD. Outcomes: In the course of IgG4-RD, the patient developed bilateral optic perineuritis, causing bilateral visual loss. Colon cancer with synchronous multiple liver metastases was found 1 year after rituximab treatment. Lessons: This case raises the possibility of IgG4-RD being a paraneoplastic syndrome in some patients. Cancer screening should probably be performed in some elderly patients diagnosed with IgG4-RD.