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Case Reports
. 2022 Apr 21;13(1):282-285.
doi: 10.1159/000524114. eCollection 2022 Jan-Apr.

Third Cranial Nerve Palsy after Monoclonal Antibody Therapy for Lung Cancer: A Case Report

Paolo Missori  1 , Angela Ambrosone  1 , Leonardo Cristofani  2 , Francesco Fattapposta  3 , Antonio Currà  4
Affiliations
Case Reports

Third Cranial Nerve Palsy after Monoclonal Antibody Therapy for Lung Cancer: A Case Report

Paolo Missori et al. Case Rep Ophthalmol. .

Abstract

Immune checkpoint inhibitors (ICIs) have shown promise in treating cancer patients, and pembrolizumab is a monoclonal IgG4 antibody that targets a human cell surface protein (receptor) called PD-1. Among the side effects, a rare cranial nerve palsy unrelated to the surgical treatment may occur. We report a case of a woman, which after neurosurgical treatment for cerebellar metastasis presented painless third cranial nerve palsy. The benefits of ICIs have been ascertained, but side effects also take place. Neurological symptoms should be recognized early to avoid substantial morbidity, and if necessary, the oncologic treatment should be changed.

Keywords: Cancer; Cranial nerve; Lung; Metastasis; Pembrolizumab; Side effects.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Patient with complete left blepharoptosis 1 week after the first dose of pembrolizumab.
Fig. 2
Fig. 2
T2-weighted MRIs of the patient. a Normal eyes' alignment after removal of left cerebellar metastasis. b Patient complaining diplopia and recurrent left cerebellar metastasis before second surgical treatment (80 days after first surgical resection). The image shows eyes' misalignment due to left III cranial nerve palsy (asterisk), the recurrent left cerebellar metastasis but no other pathological tissue or mesencephalic alterations. c After second surgical treatment (100 days after first surgical resection), eyes' misalignment and left III cranial nerve palsy persist.
See this image and copyright information in PMC

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