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PD-1 抑制剂治疗转移性肾细胞癌引起的类肉瘤样反应和甲状腺功能减退症:病例报告及文献复习。

Sarcoid-like reaction and hypothyroidism induced by PD-1 inhibitor treatment in metastatic renal cell carcinoma: a case report and literature review.

机构信息

Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

Deparment of Radiology, Al-Ahli Hospital, Hebron, Palestine.

出版信息

BMC Pulm Med. 2024 Mar 8;24(1):123. doi: 10.1186/s12890-024-02943-9.

Abstract

BACKGROUND

Pembrolizumab is among the approved treatments for a variety of cancer types, including clear cell renal cell carcinoma (ccRCC). It has contributed to enhancing the prognosis of renal cell carcinoma. However, it is essential to be aware of the numerous potential immune-related side effects associated with its use.

CASE PRESENTATION

A 69-year-old patient with a history of metastatic renal cell carcinoma has been undergoing treatment with Pembrolizumab, an immune checkpoint inhibitor. The medication has led to the development of a sarcoid-like reaction, initially misinterpreted as cancer recurrence and progression. Additionally, the patient has experienced new-onset hypothyroidism, which has been attributed to the immunotherapy.

CONCLUSION

Clinicians, including oncologists, endocrinologists, and radiologists, should maintain a high level of suspicions and awareness regarding the potential adverse events associated with newly introduced immunotherapies like pembrolizumab. This knowledge is crucial for the accurate diagnosis and appropriate management of patients receiving these treatments.

摘要

背景

帕博利珠单抗是多种癌症类型(包括透明细胞肾细胞癌[ccRCC])的获批治疗药物之一。它有助于改善肾细胞癌的预后。然而,必须注意到与使用相关的许多潜在免疫相关的副作用。

病例介绍

一名 69 岁的转移性肾细胞癌患者正在接受免疫检查点抑制剂帕博利珠单抗治疗。该药物导致类肉瘤样反应,最初被误诊为癌症复发和进展。此外,患者还出现了新发生的甲状腺功能减退症,这归因于免疫治疗。

结论

临床医生,包括肿瘤学家、内分泌学家和放射科医生,应该对新引入的免疫疗法(如帕博利珠单抗)相关的潜在不良反应保持高度怀疑和认识。这些知识对于接受这些治疗的患者的准确诊断和适当管理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d073/10924379/31560c72e877/12890_2024_2943_Fig1_HTML.jpg

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