IgG4-related Disease of the Ovary Masquerading as Chronic Tubo-Ovarian Mass with Deep Infiltrating Endometriosis: A Diagnostic Challenge

Dr. C P Srujana, Dr. Sujata N Datti, Dr. Mounica KSN, Dr. Harshitha M

Abstract: IgG4-related disease (IgG4-RD) is a rare immune-mediated fibro-inflammatory disorder that can involve multiple organs and frequently mimics malignancy or chronic inflammatory conditions. Genital tract involvement is uncommon, and ovarian involvement is extremely rare. So far only 4 cases of ovarian involvement have been reported, with all of them mimicking malignancy followed by HPE confirmed diagnosis. The youngest reported till date was 36 years. We report a case of a 20-year-old unmarried woman presenting with long-standing lower abdominal pain and cyclical bleeding per rectum, clinically and radiologically suggestive of a chronic tubo-ovarian mass with deep infiltrating endometriosis. Imaging had revealed a complex adnexal mass with pelvic adhesions and right-sided hydroureteronephrosis. The patient underwent exploratory laparotomy with right salpingo-oophorectomy following bilateral ureteric stenting. Histopathological examination revealed dense lymphoplasmacytic infiltration with fibrosis, consistent with IgG4-related disease of the ovary confirmed on IHC. This case highlights the diagnostic dilemma posed by ovarian IgG4-RD and emphasizes the importance of histopathology and immunohistochemistry in establishing the diagnosis and preventing unnecessary radical surgery.

Keywords: IgG4-related disease, Ovary, Tubo-ovarian mass, Endometriosis, Pseudotumor

How to Cite?: Dr. C P Srujana, Dr. Sujata N Datti, Dr. Mounica KSN, Dr. Harshitha M, "IgG4-related Disease of the Ovary Masquerading as Chronic Tubo-Ovarian Mass with Deep Infiltrating Endometriosis: A Diagnostic Challenge", Volume 15 Issue 3, March 2026, International Journal of Science and Research (IJSR), Pages: 1273-1275, https://www.ijsr.net/getabstract.php?paperid=SR26321051635, DOI: https://dx.doi.org/10.21275/SR26321051635

Download Citation: APA | MLA | BibTeX | EndNote | RefMan