Minor salivary IgG-4 related sialadenitis - Clinical and diagnostic challenges

IgG-4 related sialadenitis is a head and neck manifestation of an IgG4-related systemic disease. Here, we report a case of a 60 year-old woman presenting with three meta-synchronous head neck masses in the course of five years: Bilateral submandibular gland masses and a hard palate mass. Final diagnosis of IgG-4 related sialadenitis was made following the first excision, yet the initial suspected diagnosis was of lymphoma. After another submandibular mass, the patient presented with a hard palate mass, eventually diagnosed as IgG-4 related sialadenitis. In conclusion, IgG-4 related sialadenitis not limited to the submandibular gland and may appear in minor salivary glands as well.