使用伊匹单抗进行CTLA-4阻断治疗可使一名黑色素瘤发生中枢神经系统转移的女性患者获得显著的临床益处。
CTLA-4 blockade with ipilimumab induces significant clinical benefit in a female with melanoma metastases to the CNS.
作者信息
Hodi F Stephen, Oble Darryl A, Drappatz Jan, Velazquez Elsa F, Ramaiya Nikhil, Ramakrishna Naren, Day Arthur L, Kruse Andrea, Mac Rae Suzanne, Hoos Axel, Mihm Martin
机构信息
Melanoma Program, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
出版信息
Nat Clin Pract Oncol. 2008 Sep;5(9):557-61. doi: 10.1038/ncponc1183. Epub 2008 Jul 29.
BACKGROUND
A 63-year-old female presented to her primary physician with numbness and weakness in her left leg, which progressed over several days to involve her entire lower extremities. MRI of the spine and brain revealed multiple metastases. The patient received ipilimumab and after 3 months experienced intermittent confusion and focal seizures.
INVESTIGATIONS
Electroencephalogram and MRI scans of the spine and brain, followed by surgical removal of a left frontal cortical brain metastasis and subsequent histological and pathological analyses.
DIAGNOSIS
Metastatic melanoma from an unknown primary tumor.
MANAGEMENT
The patient was treated with ipilimumab on a compassionate-use program and dexamethasone, celecoxib, and levetiracetam to treat the symptoms and seizures. Postoperative stereotactic radiosurgery was initiated.
背景
一名63岁女性因左腿麻木和无力就诊于她的初级保健医生，症状在数天内进展至累及整个下肢。脊柱和脑部的MRI显示多处转移。患者接受了伊匹单抗治疗，3个月后出现间歇性意识模糊和局灶性癫痫发作。
检查
进行脑电图以及脊柱和脑部的MRI扫描，随后手术切除左额叶皮质脑转移瘤，并进行后续的组织学和病理学分析。
诊断
原发肿瘤不明的转移性黑色素瘤。
治疗
患者在同情用药计划下接受伊匹单抗治疗，并使用地塞米松、塞来昔布和左乙拉西坦治疗症状和癫痫发作。术后开始进行立体定向放射外科治疗。
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