A 60-year-old Woman With an Incidentally Discovered Right Renal Mass

      A 60-year-old woman presented to our clinic for evaluation of a right renal mass, incidentally discovered on a computed tomography (CT) scan obtained during a workup for shortness of breath. Her medical history was significant for hypertension, hyperlipidemia, hypothyroidism, and asthma. She had undergone several abdominal surgeries, including laparoscopic gastric banding, splenectomy, hysterectomy, and bilateral salpingo-oophorectomy. She denied a history of tobacco, heavy alcohol, or illicit drug use. She had no family history of kidney disease or genitourinary malignancy. On a review of systems, she reported intermittent nausea, vomiting, and dyspepsia but denied fevers, night sweats, weight loss, gross hematuria, dysuria, or a change in bowel habits. Her vitals signs were within normal limits, and her body mass index was 32.4 kg/m2. Her abdomen was soft, not distended, and without palpable masses, although several surgical scars were present. Routine laboratory tests, including complete blood count, electrolytes, creatinine, coagulation studies, and urinalysis, were performed. The complete blood count with differential demonstrated mild thrombocytosis (473 K/μL) and leukocytosis (13 K/μL) but was otherwise normal. The results from the remainder of the laboratory studies were also within normal limits.
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        • Divatia M.
        • Kim S.A.
        • Ro J.Y.
        IgG4-related sclerosing disease, an emerging entity: a review of a multi-system disease.
        Yonsei Med J. 2012; 53: 15-34
        • Kawano M.
        • Saeki T.
        • Nakashima H.
        • et al.
        Proposal for diagnostic criteria for IgG4-related kidney disease.
        Clin Exp Nephrol. 2011; 15: 615-626
        • Saeki T.
        • Nishi S.
        • Imai N.
        • et al.
        Clinicopathological characteristics of patients with IgG4-related tubulointerstitial nephritis.
        Kidney Int. 2010; 78: 1016-1023
        • Stone J.H.
        • Zen Y.
        • Deshpande V.
        IgG4-related disease.
        N Engl J Med. 2012; 366: 539-551
        • Abraham S.C.
        • Wilentz R.E.
        • Yeo C.J.
        • et al.
        Pancreaticoduodenectomy (Whipple resections) in patients without malignancy: are they all “chronic pancreatitis”?.
        Am J Surg Pathol. 2003; 27: 110-120
        • Kamisawa T.
        • Funata N.
        • Hayashi Y.
        • et al.
        A new clinicopathological entity of IgG4-related autoimmune disease.
        J Gastroenterol. 2003; 38: 982-984
        • Carruthers M.N.
        • Stone J.H.
        • Khosroshahi A.
        The latest on IgG4-RD: a rapidly emerging disease.
        Curr Opin Rheumatol. 2012; 24: 60-69
        • Umehara H.
        • Okazaki K.
        • Masaki Y.
        • et al.
        Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011.
        Mod Rheumatol. 2012; 22: 21-30
        • Saeki T.
        • Nishi S.
        • Ito T.
        • et al.
        Renal lesions in IgG4-related systemic disease.
        Intern Med. 2007; 46: 1365-1371
        • Cornell L.D.
        • Chicano S.L.
        • Deshpande V.
        • et al.
        Pseudotumors due to IgG4 immune-complex tubulointerstitial nephritis associated with autoimmune pancreatocentric disease.
        Am J Surg Pathol. 2007; 31: 1586-1597
        • Saeki T.
        • Saito A.
        • Yamazaki H.
        • et al.
        Tubulointerstitial nephritis associated with IgG4-related systemic disease.
        Clin Exp Nephrol. 2007; 11: 168-173
        • Watson S.J.
        • Jenkins D.A.
        • Bellamy C.O.
        Nephropathy in IgG4-related systemic disease.
        Am J Surg Pathol. 2006; 30: 1472-1477
        • Khosroshahi A.
        • Stone J.H.
        Treatment approaches to IgG4-related systemic disease.
        Curr Opin Rheumatol. 2011; 23: 67-71
        • Khosroshahi A.
        • Carruthers M.N.
        • Deshpande V.
        • et al.
        Rituximab for the treatment of IgG4-related disease: lessons from 10 consecutive patients.
        Medicine (Baltimore). 2012; 91: 57-66