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

Abstract

AbstractAimTo highlight the need to include IgG4 disease in the differential diagnosis of head and neck squamous cell carcinoma (SCC).MethodWe 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.ResultsBoth 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.ConclusionsTreatment 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.