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Case Reports
. 2022 Aug 1;61(15):2339-2341.
doi: 10.2169/internalmedicine.8688-21. Epub 2022 Jan 13.

Inflammatory Thoracic Aortic Aneurysm in a Patient with Advanced Lung Adenocarcinoma Treated with Pembrolizumab

Ryusuke Ninomiya  1 , Yuhei Kinehara  1 , Satoshi Tobita  1 , Hachiro Konaka  1 , Ryu Jokoji  2 , Takashi Shintani  3 , Isao Tachibana  1
Affiliations
Case Reports

Inflammatory Thoracic Aortic Aneurysm in a Patient with Advanced Lung Adenocarcinoma Treated with Pembrolizumab

Ryusuke Ninomiya et al. Intern Med. .

Abstract

A 57-year-old man with lung adenocarcinoma was treated with chemotherapy and immune checkpoint blockade. After two cycles of carboplatin, pemetrexed, and pembrolizumab, he developed a persistent fever. Chest computed tomography (CT) suggested inflammation of the aortic wall. We treated the patient with corticosteroids. After four cycles of carboplatin, pemetrexed, and pembrolizumab, chest CT showed an aneurysm in the ascending aorta. We diagnosed him with inflammatory thoracic aortic aneurysm induced by pembrolizumab and performed surgical replacement of the ascending aorta. Although this might be a very rare case, we should be aware of aortitis as a potential adverse effect of pembrolizumab.

Keywords: aortitis; immune-related adverse events; inflammatory thoracic aortic aneurysm; pembrolizumab.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Clinical course. The red and green arrows indicate inflammatory thickening of the vessels in the aortic arch and increased density around the vessels in the aortic arch. The blue arrows indicate the aneurysm. CBDCA: carboplatin, PEM: pemetrexed, CRP: C-reactive protein
Figure 2.
Figure 2.
Elastica van Gieson stain. The arrows indicate the disruption of elastic fibers in the media of the aorta.
See this image and copyright information in PMC

References

    1. Hellmann MD, Paz-Ares L, Bernabe Caro R, et al. . Nivolumab plus ipilimumab in advanced non-small-cell lung cancer. N Engl J Med 388: 2020-2031, 2019. - PubMed
    1. Borghaei H, Paz-Ares L, Horn L, et al. . Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med 373: 1627-1639, 2015. - PMC - PubMed
    1. Reck M, Rodriguez-Abreu D, Robinson AG, et al. . Pembrolizumab versus chemotherapy for PD-L1-positive non-small-cell lung cancer. N Engl J Med 375: 1823-1833, 2016. - PubMed
    1. Rittmeyer A, Barlesi F, Waterkamp D, et al. . Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial. Lancet 389: 255-265, 2017. - PMC - PubMed
    1. Gandhi L, Rodriguez-Abreu D, Gadgeel S, et al. . Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer. N Engl J Med 378: 2078-2092, 2018. - PubMed

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