Tomizawa Mitsuru, Nakai Yasushi, Maesaka Fumisato, Owari Takuya, Hara Ryota, Miyake Makito, Inoue Takeshi, Anai Satoshi, Tanaka Nobumichi, Fujimoto Kiyohide
The Department of Urology, Nara Medical University.
The Department af Orthapedics, Nara Medical University.
Hinyokika Kiyo. 2018 Oct;64(10):397-401. doi: 10.14989/ActaUrolJap_64_10_397.
A 66-year-old man underwent nephrectomy for right renal cell carcinoma (cT3bNOMl (PUL)). Thereafter, he was treated with sunitinib for lung metastasis as the first-line therapy for 5 months and then axitinib as the second-line therapy for 2 months. Because lung metastasis progressed despite molecular targeted therapies, nivolumab was used as the third-line treatment. Three months later, he complained of painful stiffness in hands and wrist joints symmetrically. He was diagnosed as having rheumatoid arthritis. Treatment with nivolumab was discontinued and prednisolone and methotrexate were started. Although the painful stiffness in joints was improved l month later, synovitis remained partially 6 months after starting treatment of disease with anti-rheumatic drugs. Therefore, treatment for rheumatoid arthritis was continued. On the other hand, because the lung lesion had progressed 2 months after discontining nivolumab, everolimus was used as the fourth-line therapy.
一名66岁男性因右肾细胞癌（cT3bN0M1（PUL））接受了肾切除术。此后，他接受舒尼替尼作为一线治疗用于肺转移，治疗5个月，然后接受阿昔替尼作为二线治疗2个月。尽管进行了分子靶向治疗，但肺转移仍有进展，于是使用纳武单抗作为三线治疗。三个月后，他对称地抱怨双手和腕关节疼痛僵硬。他被诊断为类风湿性关节炎。停用纳武单抗，开始使用泼尼松龙和甲氨蝶呤治疗。尽管1个月后关节疼痛僵硬有所改善，但在开始使用抗风湿药物治疗疾病6个月后，滑膜炎仍部分存在。因此，继续进行类风湿性关节炎的治疗。另一方面，由于停用纳武单抗2个月后肺部病变有进展，使用依维莫司作为四线治疗。
