World J Clin Cases. Jun 26, 2022; 10(18): 6269-6276 Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6269
Clivus-involved immunoglobulin G4 related hypertrophic pachymeningitis mimicking meningioma: A case report
Yang Yu, Liang Lv, Sen-Lin Yin, Cheng Chen, Shu Jiang, Pei-Zhi Zhou
Yang Yu, Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Liang Lv, Sen-Lin Yin, Cheng Chen, Shu Jiang, Pei-Zhi Zhou, Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Yu Y collected the data, contacted with the patient, and wrote the manuscript; Lv L wrote and revised the manuscript; Chen C and Yin SL made the revision to the primary manuscript; Jiang S and Zhou PZ supervised the whole work and made the operation.
Supported by1·3·5 Project for Disciplines of Excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University, No. 2019HXFH018.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Pei-Zhi Zhou, MD, Associate Professor, Surgeon, Department of Neurosurgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. peizhizhou@126.com
Received: December 13, 2021 Peer-review started: December 13, 2021 First decision: February 14, 2022 Revised: February 23, 2022 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: June 26, 2022 Processing time: 185 Days and 11.1 Hours
Core Tip
Core Tip: Immunoglobulin G4 related disease (IgG4-RD) is a fibroinflammatory disease with markedly elevated serum IgG4 levels and fibrous tissue proliferation, accompanied by numerous plasma cells. It is known to affect multiple organs. IgG4-related hypertrophic pachymeningitis (IgG4-RHP) is relatively rare and indistinguishable from IgG4-RD before the operation. Herein, we present a rare case of IgG4-RHP with intact magnetic resonance imaging and pathologic images. The case highlighted the differential diagnosis with other phymatoid lesions such as meningioma, fungal infection, and tuberculosis and the importance of comprehensive multidisciplinary treatment. Surgery becomes necessary when lesions progress and patients start to develop cranial nerve function deficit.
