IJU case reports · 2025
Sarcoid-Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma.
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Fukushima Kanta, Mizukoshi Sota, Ino Tomohiro, Ishida Takuya, Ito Yumika, Okimura Akira, Nakatsugawa Munehide, Hashimoto Takeshi
Аннотация
INTRODUCTION: Immune checkpoint inhibitors (ICIs) are useful in the treatment of metastatic renal cell carcinoma. ICIs have been associated with a variety of immune-related adverse events (irAEs), one of which is a sarcoid-like reaction (SLR). SLR is often difficult to distinguish from cancer progression.
CASE PRESENTATION: The patient is a 71-year-old woman. She underwent laparoscopic nephrectomy after 4 courses of ipilimumab + nivolumab therapy for clear cell renal cell carcinoma with femoral bone metastasis. In the pathological examination, in addition to tumor-infiltrating lymphocytes, numerous non-caseating epithelioid cell granulomas were found in the tumor. The occurrence of non-caseating epithelioid cell granuloma in a patient who did not meet the diagnostic criteria for systemic sarcoidosis was considered SLR due to ICI.
CONCLUSIONS: We report the first case of a patient who underwent surgery for metastatic renal cell carcinoma after treatment with ICI and who was pathologically diagnosed with SLR in the kidney.
CASE PRESENTATION: The patient is a 71-year-old woman. She underwent laparoscopic nephrectomy after 4 courses of ipilimumab + nivolumab therapy for clear cell renal cell carcinoma with femoral bone metastasis. In the pathological examination, in addition to tumor-infiltrating lymphocytes, numerous non-caseating epithelioid cell granulomas were found in the tumor. The occurrence of non-caseating epithelioid cell granuloma in a patient who did not meet the diagnostic criteria for systemic sarcoidosis was considered SLR due to ICI.
CONCLUSIONS: We report the first case of a patient who underwent surgery for metastatic renal cell carcinoma after treatment with ICI and who was pathologically diagnosed with SLR in the kidney.