Evidence map›Paper›PMID 42382652›Full record

ArticleBrain & spine2026

A case of an immunoglobulin G4 related inflammatory pseudotumor involving the clivus and the nasopharynx: A challenging case of a perplexing entity with an exhaustive overview.

Mehdi Borni, Brahim Kammoun, Moncef Sellami, Saadia Makni, Chahir Kammoun, Issam Jardak, Noura Selem, Mohamed Zaher Boudawara

Abstract readCase Reports
In one paragraph

Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mehdi BorniDepartment of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia.
Brahim KammounDepartment of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia.
Moncef SellamiDepartment of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia.
Saadia MakniDepartment of Pathology, Habib Bourguiba University Hospital, Sfax, Tunisia.
Chahir KammounPrivate Practice Pathologist, Sfax, Tunisia.
Issam JardakDepartment of Nuclear Medicine, Habib Bourguiba University Hospital, Sfax, Tunisia.
Noura SelemDepartment of Otorhinolaryngology-Head and Neck Surgery, Habib Bourguiba University Hospital, Sfax, Tunisia.
Mohamed Zaher BoudawaraDepartment of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Immunoglobulin G4-Related Disease (IgG4-RD) is a systemic fibroinflammatory condition characterized by IgG4-positive plasma cell infiltration and fibrosis, capable of affecting nearly any organ. While neurological manifestations are recognized, skull base and clival involvement are rare, and the spectrum of neurological presentations continues to expand. Research question: This case report addresses the diagnostic and therapeutic challenges of an exceedingly rare presentation of IgG4-RD involving the clivus and nasopharynx, focusing on its unique neurological phenotype and response to treatment. Material and methods: We report the case of a previously healthy 42-year-old male presenting with a three-year history of progressively intractable headaches. Initial evaluation included contrast-enhanced CT, MRI of the brain, cavum, and clival region, and a whole-body 18F-FDG PET-CT. Diagnosis was established via endoscopic biopsy of the nasopharyngeal/clival lesion followed by histopathological and immunohistochemical analysis. The patient was managed with systemic corticosteroid monotherapy. Results: Imaging showed an aggressive, hypermetabolic mass with clival osteolysis1. Histopathology confirmed IgG4-RD (IgG4+/total IgG + ratio >40\%, >100 IgG4+ cells/HPF). The patient presented with Arnold's neuralgia-like symptoms-a previously unreported neurological finding in IgG4-RD. Corticosteroid monotherapy resulted in a rapid, near-complete resolution of his headaches and favorable clinical evolution. Discussion and conclusion: This case highlights a unique, previously undescribed Arnold's neuralgia-like presentation of IgG4-RD involving the clivus and nasopharynx. Our experience supports the efficacy of corticosteroids as first-line treatment, even with rare anatomical involvement. This report underscores considering IgG4-RD in the differential diagnosis of atypical head and neck pain, particularly with clival lesions.

Indexed as

ClivusCorticosteroidsIgG4-related diseaseInflammationMRI

Identifiers

PMID42382652
PMCPMC13316640

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.