Unforeseen Complications of Pembrolizumab in Breast Reconstruction Post-Mastectomy.

Q3 Medicine

European journal of case reports in internal medicine Pub Date : 2024-07-01 eCollection Date: 2024-01-01 DOI:10.12890/2024_004675

Murad Aldarayseh, Sohail Singh Sodhi, Gamal Musleh, Dyuti Kumar, Michelle Cholankeril

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引用次数: 0

Abstract

A 53-year-old post-menopausal Indian female presented with invasive ductal carcinoma, treated with neoadjuvant chemotherapy and pembrolizumab due to a PD-L1 combined positive score of 5. Following a right mastectomy and axillary dissection, she received a breast expander and AlloDerm™ graft. After resuming pembrolizumab and paclitaxel postoperatively, she developed severe breast redness and high-grade fever, necessitating expander removal due to suspected pembrolizumab-induced complications. This case underscores the unique and severe adverse effects of pembrolizumab on breast reconstruction, highlighting the need for careful monitoring and management in patients undergoing similar treatments.

Learning points: Among patients with early triple-negative breast cancer, the combination of pembrolizumab with neoadjuvant chemotherapy enhances outcomes compared to chemotherapy alone.Early recognition is essential for managing pembrolizumab-induced complications, as demonstrated by the need for expander removal and debridement in this case.The unique adverse effects observed in this case underscore the importance of tailoring cancer treatment plans to individual patients, taking into account the potential risks associated with immunotherapy in the context of reconstructive surgery.

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Pembrolizumab 在乳房切除术后乳房重建中的意外并发症。

一名 53 岁的绝经后印度女性患有浸润性导管癌，由于 PD-L1 合并阳性评分为 5 分，她接受了新辅助化疗和 Pembrolizumab 治疗。在接受右侧乳房切除术和腋窝清扫术后，她接受了乳房扩张器和 AlloDerm™ 移植。术后恢复使用 Pembrolizumab 和紫杉醇后，她出现了严重的乳房发红和高烧，由于怀疑是 Pembrolizumab 引起的并发症，她不得不将扩胸器取出。该病例强调了pembrolizumab对乳房重建的独特而严重的不良影响，突出了对接受类似治疗的患者进行仔细监测和管理的必要性：在早期三阴性乳腺癌患者中，与单纯化疗相比，pembrolizumab与新辅助化疗的联合治疗可提高疗效。早期识别对于控制pembrolizumab引起的并发症至关重要，本病例中需要切除扩张器并进行清创就是证明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European journal of case reports in internal medicine

CiteScore

2.10

自引率

0.00%

发文量

166

审稿时长

8 weeks

期刊介绍： The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.