Nivolumab induced hypophysitis in an advanced RCC patient.

INTRODUCTION

Immune checkpoint inhibitors (ICIs) are being commonly used to treat solid tumours such as renal cell carcinoma. Hypophysitis is an acute or chronic inflammation of the pituitary gland and nivolumab or pembrolizumab induced hypophysitis is markedly lower compared to ipilimumab.

CASE REPORT: We present a novel case of a patient with mRCC who was diagnosed with nivolumab induced hypophysitis based on clinical suspicion due to his hormonal profile and a range of symptoms that he developed during nivolumab immunotherapy.

MANAGEMENT AND OUTCOME: He was treated with high dose of hydrocortisone administered intravenously, subsequently changed to the oral route and physiologic dose.

DISCUSSION: Nivolumab induced hypophysitis is a rare condition that usually presents with fewer symptoms. High degree of clinical suspicion and a multidisciplinary team required to diagnose and treat such cases.