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Case Reports
. 2023 Oct 7;17(1):420.
doi: 10.1186/s13256-023-04162-y.

Lung erosion following adjuvant immunotherapy with pembrolizumab: a case report

Lowell Leow  1 , Manisha Anbudurai  2 , Li Yue  1 , John Kit Chung Tam  3   4
Affiliations
Case Reports

Lung erosion following adjuvant immunotherapy with pembrolizumab: a case report

Lowell Leow et al. J Med Case Rep. .

Abstract

Background: Pembrolizumab as immunotherapy is increasingly used in adjuvant, neoadjuvant, and standalone therapy and has been described as safe. We share an experience of lung erosion post-thoracic surgery with the use of adjuvant pembrolizumab.

Case presentation: A 65-year-old Chinese gentleman with metastatic renal cell carcinoma underwent lung metastasis resection and presented with delayed onset pneumothorax while on adjuvant pembrolizumab. Failure of conservative management warranted repeat surgical intervention, and intraoperative findings showed erosion of staple lines possibly caused by poor healing associated with pembrolizumab.

Conclusion: Adjuvant pembrolizumab may impair wound healing, including stapler line healing. Presentation of delayed pneumothorax in a post-surgical patient undergoing immunotherapy should warrant early surgical intervention.

Keywords: Adjuvant therapy; Case report; Lung cancer; Lung surgery; Pembrolizumab.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Right lower lobe superior segment lesion (left) and right lower lobe basal segment lesion (right). Arrows indicate lesions
Fig. 2
Fig. 2
Apical pneumothorax (left) resolved (right) after superior segmentectomy surgery. Arrow indicates pneumothorax
Fig. 3
Fig. 3
Intraoperative photograph of erosion on lower lobe stapler line
Fig. 4
Fig. 4
Abnormal healing around staple line in superior segment right lower lobe, with concomitant right pneumothorax. Arrow indicates stapler line
See this image and copyright information in PMC

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