Sarcoid-Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma

Q4 Medicine

IJU Case Reports Pub Date : 2025-04-14 DOI:10.1002/iju5.70027

Kanta Fukushima, Sota Mizukoshi, Tomohiro Ino, Takuya Ishida, Yumika Ito, Akira Okimura, Munehide Nakatsugawa, Takeshi Hashimoto

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Abstract

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.

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转移性肾细胞癌中与免疫检查点抑制剂相关的肉瘤样反应(SLR

免疫检查点抑制剂（ICIs）在转移性肾细胞癌的治疗中是有用的。ICIs与多种免疫相关不良事件（irAEs）相关，其中之一是肉瘤样反应（SLR）。单反通常很难与癌症进展区分开来。患者是一名71岁的女性。她在益匹单抗+纳沃单抗治疗透明细胞肾细胞癌伴股骨骨转移4个疗程后行腹腔镜肾切除术。病理检查除肿瘤浸润性淋巴细胞外，肿瘤内可见大量非干酪化上皮样细胞肉芽肿。不符合系统性结节病诊断标准的患者出现非干酪化上皮样细胞肉芽肿，考虑为ICI所致SLR。结论：我们报告了第一例患者在接受ICI治疗后接受转移性肾细胞癌手术，病理诊断为肾脏SLR。

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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