DOAJ Open Access 2021

Case Report: Pseudomeningeosis and Demyelinating Metastasis-Like Lesions From Checkpoint Inhibitor Therapy in Malignant Melanoma

Teresa Schmidt Teresa Schmidt Teresa Schmidt Sied Kebir Sied Kebir +25 lainnya

Abstrak

Immune checkpoint inhibitors (ICIs) have considerably expanded the effective treatment options for malignant melanoma. ICIs revert tumor-associated immunosuppression and potentiate T-cell mediated tumor clearance. Immune-related neurologic adverse events (irNAEs) manifest in the central (CNS) or peripheral nervous system (PNS) and most frequently present as encephalitis or myasthenia gravis respectively. We report on a 47-year old male patient with metastatic melanoma who developed signs of cerebellar disease five weeks after the start of ICI treatment (ipilimumab and nivolumab). Magnetic resonance imaging (MRI) of the brain and spine revealed multiple new contrast enhancements suggestive of parenchymal and leptomeningeal metastasis. Cerebral spinal fluid (CSF) evaluation showed a lymphomononuclear pleocytosis in the absence of tumor cells. Subsequent stereotactic brain biopsy confirmed demyelinating disease. High-dose corticosteroid treatment resulted in immediate improvement of the clinical symptoms. MRI scans and CSF re-evaluation were conducted six weeks later and showed a near-complete remission. The strong resemblance to neoplastic CNS dissemination and irNAEs is a particularly difficult diagnostic challenge. Treating physicians should be aware of irNAEs as those can be effectively treated with high-dose steroids.

Topik & Kata Kunci

Neoplasms. Tumors. Oncology. Including cancer and carcinogens

Penulis (30)

Teresa Schmidt

Sied Kebir

Elisabeth Livingstone

Andreas Junker

Stefan Zülow

Lazaros Lazaridis

Christoph Oster

Eleftheria Chorti

Daniela Pierscianek

Refik Pul

Kathy Keyvani

Ulrich Sure

Martin Stuschke

Christoph Kleinschnitz

Björn Scheffler

Lisa Zimmer

Martin Glas

Format Sitasi

APA MLA BibTeX

Schmidt, T., Schmidt, T., Schmidt, T., Kebir, S., Kebir, S., Kebir, S. et al. (2021). Case Report: Pseudomeningeosis and Demyelinating Metastasis-Like Lesions From Checkpoint Inhibitor Therapy in Malignant Melanoma. https://doi.org/10.3389/fonc.2021.637185

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Informasi Jurnal

Tahun Terbit: 2021
Sumber Database: DOAJ
DOI: 10.3389/fonc.2021.637185
Akses: Open Access ✓