Pseudoprogression Presenting As Intestinal Perforation in Non-small Cell Lung Cancer Treated with Anti-PD-1: A Case Report

Overview

Journal Mol Clin Oncol

Specialty Oncology

Date 2019 Jul 9

PMID 31281646

Citations 8

Authors

Hee Kyung Kim

Seung-Woo Baek

Yusook Jeong

Yaewon Yang

Jihyun Kwon

Hye Sook Han

Jin-Young An

Chang Gok Woo

Ok-Jun Lee

Taek Gu Lee

Ki Hyeong Lee

Affiliations

Soon will be listed here.

Abstract

Pseudoprogression is not frequently observed in patients with non-small cell lung cancer (NSCLC) who are treated with immune checkpoint inhibitors. We report on a case of pseudoprogression, which was presented as intestinal perforation after pembrolizumab immunotherapy for NSCLC. A-54-year-old man with stage IV NSCLC received pembrolizumab therapy. The patient was admitted to our hospital because of acute abdominal pain and the computed tomography scan revealed diffuse wall thickening of the small bowel with free intraperitoneal air. Intestinal perforation was suspected and surgical resection was performed. Histological evaluation of the resected specimen showed infiltrated lymphocytes positive for CD3, CD8 with necrotic tumor cells, suggestive of an immune reaction. Although intestinal perforation after treatment with immune checkpoint inhibitors is rare, it can be an unusual presentation of pseudoprogression and clinicians should be aware of this possibility.

Citing Articles

[Advances in Pseudoprogression of Immune Checkpoint Inhibitors  in Non-small Cell Lung Cancer].

Tong Y, Long Y, Zhang F, Li J Zhongguo Fei Ai Za Zhi. 2024; 27(4):306-320.

PMID: 38769834 PMC: 11110244. DOI: 10.3779/j.issn.1009-3419.2024.101.10.

Characteristics, treatment, and outcome of patients with bowel perforation after immune checkpoint inhibitor exposure.

Machado A, Shatila M, Liu C, Lu Y, Altan M, Glitza Oliva I J Cancer Res Clin Oncol. 2023; 149(9):5989-5998.

PMID: 36611109 DOI: 10.1007/s00432-022-04569-y.

Potentials of Non-Invasive F-FDG PET/CT in Immunotherapy Prediction for Non-Small Cell Lung Cancer.

Liao X, Liu M, Wang R, Zhang J Front Genet. 2022; 12:810011.

PMID: 35186013 PMC: 8855498. DOI: 10.3389/fgene.2021.810011.

Expectoration of tonsillar metastasis of pulmonary pleomorphic carcinoma after pseudoprogression: A case report.

Kuge T, Okabe F, Yamamoto Y, Ishijima M, Uenami T, Kanazu M Thorac Cancer. 2021; 12(12):1935-1939.

PMID: 33973724 PMC: 8201531. DOI: 10.1111/1759-7714.13948.

Squamous Cell Carcinoma of the Tonsil Causing Small Bowel Perforation in the Setting of Metastasis and Treatment With Programmed Death-1 Inhibitors: A Case Report.

Dabek R, Bizanti A, Thomas S, Kalla A, Hamdallah I Cureus. 2020; 12(9):e10739.

PMID: 33029471 PMC: 7529493. DOI: 10.7759/cureus.10739.

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