Toyoshima Moe, Ikarashi Daiki, Tsuboi Hiroyuki, Moriwaka Makoto, Tamada Shinji, Matsuura Tomohiko, Maekawa Shigekatsu, Kato Renpei, Kanehira Mitsugu, Takata Ryo, Sugimura Jun, Obara Wataru
The Department of Urology, Iwate Medical University.
The Department of Rehabilitation, Iwate Medical University Hospital.
Hinyokika Kiyo. 2023 Aug;69(8):227-232. doi: 10.14989/ActaUrolJap_69_8_227.
A 73-year-old man with renal cell carcinoma underwent a left-sided open radical nephrectomy at our center. The pathological diagnosis was Fuhrman Grade 2, stage pT3a, clear cell renal cell carcinoma. A follow-up computed tomography (CT) scan revealed lung metastases 9 months after the surgery. The patient was started on ipilimumab with nivolumab combination therapy; however, after two cycles of administration, he developed arthralgia and swelling of the knee. Furthermore, he developed diarrhea almost simultaneously, resulting in the interruption of the ipilimumab plus nivolumab treatment. We diagnosed arthritis and colitis with immune-related adverse events (irAE) and initiated steroid therapy with rehabilitation. His condition improved dramatically, and nivolumab treatment could be resumed after 3 months of treatment interruption.
一名73岁的肾细胞癌男性患者在我们中心接受了左侧开放性根治性肾切除术。病理诊断为富尔曼2级，pT3a期，透明细胞肾细胞癌。术后9个月的随访计算机断层扫描（CT）显示有肺转移。患者开始接受伊匹单抗联合纳武单抗治疗；然而，在两个疗程的给药后，他出现了关节痛和膝盖肿胀。此外，他几乎同时出现腹泻，导致伊匹单抗加纳武单抗治疗中断。我们诊断为关节炎和结肠炎伴免疫相关不良事件（irAE），并开始使用类固醇治疗并进行康复治疗。他的病情显著改善，在治疗中断3个月后可以恢复纳武单抗治疗。
