From the *Department of Medical Radiology, Division of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; †Department of Medical Radiology, Divisions of Nuclear Medicine and Neuroradiology, University Hospital Zurich, Zurich, Switzerland; and ‡Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Clin Nucl Med. 2015 Nov;40(11):e518-9. doi: 10.1097/RLU.0000000000000887.
Ipilimumab is a monoclonal antibody against the inhibitory CTLA-4 receptor expressed on T cells. It provokes an upregulation of the immune system. This substance was approved by the US Food and Drug Administration in 2011 and is since increasingly used as a targeted therapeutic approach for metastasized melanoma. Ipilimumab is known to cause neuroendocrine disorders, such as hypophysitis and adrenal insufficiency. Our case of a 79-year-old patient represents an important imaging pitfall. Imaging findings of newly symmetrically and smoothly enlarged, hypermetabolic adrenal glands in the setting of previous ipilimumab therapy represent drug-induced adrenalitis and not metastatic disease.
依匹单抗是一种针对 T 细胞表面表达的抑制性 CTLA-4 受体的单克隆抗体。它能促进免疫系统的上调。该物质于 2011 年获得美国食品和药物管理局批准，此后被越来越多地用作转移性黑色素瘤的靶向治疗方法。依匹单抗可引起神经内分泌紊乱，如垂体炎和肾上腺功能不全。我们的 79 岁患者的病例代表了一个重要的影像学陷阱。在先前的依匹单抗治疗背景下，新出现的双侧、对称、平滑性增大、高代谢肾上腺的影像学表现提示药物性肾上腺炎，而非转移性疾病。
