Ha Fushuang, Wang Haoyu, Cai Junjun, Liang Jing, Liu Hua
Hepatology and Gastroenterology Department, The Third Central Hospital of Tianjin, Tianjin, People's Republic of China.
Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin, People's Republic of China.
Cancer Manag Res. 2025 Aug 27;17:1819-1823. doi: 10.2147/CMAR.S524543. eCollection 2025.
We describe the case of an older male patient with hepatocellular carcinoma and a history of hepatitis B virus-related cirrhosis and type 2 diabetes mellitus. At 12 weeks after treatment with transcatheter arterial chemoembolization (TACE) combined with systemic therapy using lenvatinib and camrelizumab, the patient was found to have progressive disease, based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. He also exhibited symptoms such as left eyelid ptosis and limitations in inward, upward, and downward movements of the left eye. The possibility of immune checkpoint inhibitor-induced myasthenia gravis was considered. After relevant examinations including electromyography and repetitive nerve stimulation, a diagnosis of oculomotor nerve palsy induced by diabetes-related microvascular dysfunction was ultimately considered. Subsequently, the patient was treated with camrelizumab combined with regorafenib and TACE therapy and was concurrently subjected to stricter glycemic control and neurotrophic treatment. Three months later, the ocular symptoms disappeared, and the mRECIST assessment revealed the achievement of a partial response. At the time of manuscript submission, the overall survival of the patient had reached 81 months.
我们描述了一例老年男性患者，患有肝细胞癌，有乙肝病毒相关肝硬化和2型糖尿病病史。在经动脉化疗栓塞术（TACE）联合使用乐伐替尼和卡瑞利珠单抗进行全身治疗12周后，根据实体瘤改良疗效评价标准（mRECIST），该患者被发现疾病进展。他还出现了左眼睑下垂以及左眼内收、上抬和下视运动受限等症状。考虑了免疫检查点抑制剂诱发重症肌无力的可能性。经过包括肌电图和重复神经电刺激在内的相关检查后，最终考虑诊断为糖尿病相关微血管功能障碍所致动眼神经麻痹。随后，该患者接受了卡瑞利珠单抗联合瑞戈非尼及TACE治疗，同时进行了更严格的血糖控制和神经营养治疗。三个月后，眼部症状消失，mRECIST评估显示达到部分缓解。在提交本文时，该患者的总生存期已达81个月。
