Nivolumab-Associated Pulmonary and Bone Sarcoidosis in a Patient With Melanoma of Unknown Primary

A 57-year-old man with stage IIIB malignant melanoma of unknown primary presented for pretherapy FDG PET/CT that demonstrated metastatic left cervical lymph node with no other site of involvement. Following left neck dissection, nivolumab was initiated. Follow-up FDG PET/CT 3 months after initiation of nivolumab demonstrated extensive radiotracer-avid chest lymphadenopathy and multiple bone lesions. Ultrasound-guided endobronchial biopsy of the mediastinal lymph nodes demonstrated sarcoidosis.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Related Links:

We report a case of a 50-year-old woman treated with anti–PD-1 inhibition for metastatic melanoma. During treatment, extensive and transient histopathologically confirmed sarcoid-like reaction was detected in multiple organ systems and at different time points using 18F-FDG PET/CT imaging. Immune-related adverse events during anti-PD-1/PD-L1 antibody treatment are increasingly being reported. This case report emphasizes the broad spectrum of possible presentations of sarcoid-like reaction detected by 18F-FDG PET/CT and its evolution in time. For the clinician, awareness of these immune-related adverse events helps to...
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
We report a similar new case strongly suggesting a specific effect of this drug combination. PATIENTS AND METHODS: A 58-year-old man bearing 20-year-old tattoos was treated with dabrafenib and trametinib for advanced melanoma. A painful erythematous swelling appeared on all the patient's tattoos two months later, while his general tolerance of the treatment was poor. Skin biopsy demonstrated perivascular lympho-histiocytic infiltrate without granuloma, but with prominent pigment-loaded macrophages. Inflammatory signs quickly regressed after drug discontinuation. DISCUSSION: Great similarity exists between this ne...
Source: Annales de Dermatologie et de Cenereologie - Category: Dermatology Authors: Tags: Ann Dermatol Venereol Source Type: research
AbstractBackgroundMelanoma patients have shown sarcoid-like lesions as an immune-related adverse event to anti-PD-1 immunotherapy. Proper discrimination is essential for accurate treatment decision. Aim of the study is to distinguish granulomatous disease (GD) from pulmonary metastases (MET) and enlarged intrapulmonary lymph nodes (LN) in melanoma patients treated with immune checkpoint blockade by using deep learning.MethodsRetrospective (2012-2018) analysis of 165 melanoma patients treated with anti-PD-1 immunotherapy. All patients underwent standardized imaging-based tumor response assessment with contrast enhanced comp...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Introduction: Sarcoidosis is an inflammatory multisystemic disease. Cutaneous sarcoidosis is referred to as the great imitator because of a myriad of possible skin lesions. It can infiltrate scars. One case of subcutaneous sarcoidosis in a melanoma scar has been reported. No cutaneous sarcoidosis with epidermal or dermal change arising in a melanoma scar has been found in the literature.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Nivolumab, a checkpoint inhibitor of programmed cell death receptor-1 (PD-1), is used in the treatment of metastatic melanoma and nonsmall cell lung cancer. Blockade of PD-1 receptor releases inhibition of T-cell activation and allows for an antitumor immune response. As with many immune-mediated therapeutics, the most common cutaneous immune-related adverse events reported in association with nivolumab are vitiligo, rash and pruritis. Other autoimmune and inflammatory skin conditions such as psoriasiform or lichenoid eruptions, autoimmune blistering disorders, and sarcoidosis have also been reported.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Authors: Tattevin P, Tchamgoué S, Belem A, Bénézit F, Pronier C, Revest M Abstract Aseptic meningitis is defined as meningeal inflammation - i.e. cerebrospinal fluid (CSF) pleocytosis≥5 cells/mm3 - not related to an infectious process. Etiologies of aseptic meningitis can be classified in three main groups: (i) systemic diseases with meningeal involvement, which include sarcoidosis, Behçet's disease, Sjögren's syndrome, systemic lupus erythematosus and granulomatosis with polyangiitis; (ii) drug-induced aseptic meningitis, mostly reported with non-steroidal an...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
AbstractImmune checkpoint inhibitors targeting the cytotoxic T lymphocyte-associated antigen-4 and programmed cell death-1 receptors have transformed the treatment of melanoma and other cancers. These therapies are associated with a number of side effects, including immune-related adverse events. Sarcoidosis-like granulomas (SLGs) are important immune checkpoint inhibitor-related reactions to recognize as SLGs can mimic disease progression and accordingly impact treatment decisions. We systematically review reports of immune checkpoint inhibitor-induced SLGs in cancer patients and discuss potential underlying pathophysiological mechanisms.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
647Objectives: In advanced melanoma, combined immune checkpoint inhibitors (ICIs) against cytotoxic T-lymphocyte-associated-antigen-4 (CTLA-4, Ipilimumab) and programed cell death-1 (PD-1, Nivolumab) have higher efficacy and more immune-related adverse events (irAEs) compared to single agent PD-1 therapy. We evaluated the role of FDG-PET/CT in response assessment and irAEs detection following first-line combined ICIs therapy in advanced melanoma. Methods: Between 2015 and 2018, 121 patients received nivolumab (1 mg/kg of body weight) plus ipilimumab (3 mg/kg) every 3 weeks for four cycles, followed by nivolumab (3 mg/kg) e...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Sarcoma/ Melanoma Source Type: research
Conclusions: Focal increased FDG metabolic activity in the parotid gland require further investigation especially in the head and neck malignancy or if the results may change treatment plan as many will have unexpected metastasis.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Other Solid Tumors Posters Source Type: research
[Enlarged mediastinal lymph nodes of a patient with malignant melanoma stage IV under pembrolizumab treatment]. Hautarzt. 2019 Mar 18;: Authors: Nikolakis G, Brunner M, Boye H, Arndt N, Altenburg A, Vaiopoulos A, Zouboulis CC Abstract A 40-year-old patient with malignant melanoma pT4bN0M1a stage IV (AJCC classification 2017) was treated with the PD-1/PD-L1 antibody pembrolizumab. Three months after treatment initiation the patient developed enlarged mediastinal lymph nodes despite the partial response of the cutaneous metastases. An elective lymph node extirpation was performed...
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
More News: Cancer & Oncology | Cervical Discectomy | Melanoma | Nuclear Medicine | Sarcoidosis | Skin Cancer | Ultrasound