# An Evasive Liver Mass in a Human Immunodeficiency Virus (HIV)-Positive Patient

## TL;DR

A rare case of a liver lesion caused by an autoimmune condition resolved on its own in a patient with HIV.

## Contribution

This is the first reported case of spontaneous remission of IgG4-related liver disease in an HIV-positive patient.

## Key findings

- IgG4-related disease can manifest as a liver mass in HIV-positive individuals.
- Spontaneous remission of IgG4-related liver lesions is extremely rare and previously undocumented in HIV-positive patients.

## Abstract

IgG4-related disease (IgG4-RD) is an autoimmune syndrome that is characterized by elevated levels of serum IgG4 and infiltration of various tissue types by IgG4 immunoreactive plasma cells. The IgG4-RD can result in systemic disease and the formation of inflammatory mass lesions, frequently addressed as pseudotumors. While IgG4-RD can manifest in various organs, liver involvement is rare, and because it is an immune-mediated inflammatory process, it is uncommon in patients who are immunocompromised. Furthermore, despite IgG4-RD responding well to immunosuppressive treatment, cases of spontaneous remission are exceedingly rare in the literature. In this report, we present the unique case of a self-resolving IgG4-RD lesion of the liver in a HIV positive patient.