Case Reports in Oncology最新文献

{"title":"Metastatic Renal Cell Carcinoma with Concomitant Minimal Change Disease: Enabling Immunotherapy with Rituximab - A Case Report.","authors":"Alexandre Faco Junior, Mohammad Amin Salehi, Mohammad Hassan Hodroj, Ratna Samanta, Ramy Saleh","doi":"10.1159/000553260","DOIUrl":"10.1159/000553260","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICIs) have transformed the treatment of metastatic renal cell carcinoma (RCC). Their use in patients with preexisting autoimmune diseases is challenging due to the risk of flares and the impact of baseline immunosuppression on treatment effectiveness. Minimal change disease (MCD), an immune-mediated glomerulopathy usually managed with corticosteroids and other immunosuppressants, poses a therapeutic challenge for immunotherapy.</p><p><strong>Case presentation: </strong>We report the case of a 44-year-old man diagnosed with metastatic clear cell RCC with sarcomatoid differentiation, who also had a history of steroid-dependent MCD. To enable immunotherapy, we collaborated with nephrology to adjust the patient's immunosuppressive regimen. The patient was transitioned from prednisone and cyclosporine to rituximab (1 g intravenously on days 1 and 15) as a steroid-sparing strategy. Cabozantinib monotherapy was initiated to address the high tumor burden while immunosuppression was being optimized. Following successful tapering of corticosteroids and discontinuation of the calcineurin inhibitor, nivolumab was subsequently added. The patient developed immune-related hypothyroidism, which was successfully managed with hormone replacement. Restaging imaging demonstrated radiological response, and treatment was continued with good tolerance.</p><p><strong>Conclusion: </strong>This case underscores the importance of multidisciplinary management for patients with cancer and concurrent autoimmune disease. Adjusting baseline immunosuppression with targeted strategies, such as B-cell depletion, may be a practical approach to enable immunotherapy while maintaining control of autoimmune conditions. Careful selection of treatment and personalized therapy may facilitate safe and effective ICI-based treatment in selected patients with metastatic RCC and MCD.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1148-1155"},"PeriodicalIF":0.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Enfortumab Vedotin and Pembrolizumab in 2 Hemodialysis Patients with Metastatic Urothelial Carcinoma: A Case Series.","authors":"Akihiro Maeda, Shohei Tobu, Shuhei Kusano, Maki Kawasaki, Hiroaki Kakinoki, Mitsuru Noguchi","doi":"10.1159/000553314","DOIUrl":"10.1159/000553314","url":null,"abstract":"<p><strong>Introduction: </strong>Enfortumab vedotin plus pembrolizumab (EV-P) is a new first-line treatment for metastatic urothelial carcinoma; however, its safety and efficacy in patients undergoing maintenance hemodialysis remain unclear because such patients were excluded from pivotal clinical trials. We report 2 hemodialysis patients with metastatic urothelial carcinoma treated with EV-P.</p><p><strong>Case presentation: </strong>The first patient was a 78-year-old man with bladder cancer who developed pulmonary metastases. Because he also had a history of primary lung adenocarcinoma, computed tomography-guided biopsy was performed and confirmed metastatic urothelial carcinoma. EV-P was initiated on non-dialysis days. Grade 1 skin toxicity developed and required topical corticosteroid treatment and stepwise dose reduction of enfortumab vedotin. After three cycles, computed tomography showed a partial response, which was maintained after seven cycles and remained durable for 11 months after treatment initiation, even after treatment discontinuation. The second patient was a 62-year-old man with right upper tract urothelial carcinoma who developed multiple liver metastases and peritoneal dissemination after robot-assisted right nephroureterectomy. EV-P was initiated on non-dialysis days. After three cycles, computed tomography showed shrinkage of the liver metastases and peritoneal lesions, consistent with a partial response. At the latest follow-up, he had completed nine cycles, and the response was maintained without severe adverse events.</p><p><strong>Conclusion: </strong>These cases suggest that EV-P may be a treatment option for selected hemodialysis patients with metastatic urothelial carcinoma.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1138-1147"},"PeriodicalIF":0.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dry Pleural Dissemination from Rectal Cancer: A Case Report.","authors":"Hiroshi Shintani, Katsuji Tokuhara, Naoki Kataoka","doi":"10.1159/000553299","DOIUrl":"10.1159/000553299","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant pleural disease is a manifestation of advanced malignancy and may present as malignant pleural effusion or solid pleural metastases. Dry pleural dissemination (DPD), defined as pleural metastases without pleural effusion, had been typically described in primary lung cancer but is rarely reported in metastatic malignancies.</p><p><strong>Case presentation: </strong>A 79-year-old woman underwent laparoscopic low anterior resection for rectal cancer. On follow-up after 3 years and 5 months, computed tomography (CT) revealed two enlarging lung nodules along the right interlobar fissure without pleural effusion. Positron emission tomography-CT demonstrated mild uptake in these nodules, and there were no other lesions identified. Tumor marker levels showed increasing carcinoembryonic antigen and normal carbohydrate antigen 19-9. During thoracoscopic surgery for suspected pulmonary metastases, multiple small nodules were seen diffusely distributed on the parietal and visceral pleura without pleural effusion. Histopathological examination revealed metastatic rectal adenocarcinoma, leading to a diagnosis of DPD.</p><p><strong>Discussion: </strong>DPD is considered early-stage pleural metastasis and is difficult to detect due to the absence of pleural effusion. Most reports on DPD are limited to primary lung cancer, and its occurrence in metastatic colorectal cancer is extremely rare. In this patient, only a small number of lesions were detectable on imaging, whereas numerous pleural nodules were identified intraoperatively. This discrepancy highlighted the limitations of imaging modalities in detecting early pleural dissemination. Clinicians should consider the possibility of occult pleural metastasis, including DPD, in patients with rising tumor marker levels even when imaging findings are inconclusive.</p><p><strong>Conclusion: </strong>This case illustrated a rare presentation of rectal cancer recurrence as DPD. Awareness of this entity and consideration of thoracoscopic evaluation may facilitate early diagnosis and timely therapeutic intervention.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1115-1121"},"PeriodicalIF":0.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Cancer Associated with Muir-Torre Syndrome: A Rare Case Report and Literature Review.","authors":"Charles Marchand-Crety, Nicolas Jacquin","doi":"10.1159/000551667","DOIUrl":"10.1159/000551667","url":null,"abstract":"<p><strong>Introduction: </strong>Muir-Torre syndrome (MTs) is a rare autosomal dominant disorder characterized by sebaceous neoplasms and internal malignancies, most commonly colorectal and urothelial cancers. Prostate cancer is exceptionally rare in MTs, with only thirteen cases reported to date.</p><p><strong>Case presentation: </strong>We present the case of a 65-year-old male initially diagnosed with MTs following the development of multiple sebaceous tumors and identification of a heterozygous MSH6 mutation. Immunohistochemistry demonstrated isolated loss of MSH6 protein expression, with preserved microsatellite stability - an unusual finding in MTs. Despite two negative prostate biopsies and a transurethral resection, choline positron emission tomography imaging revealed hypermetabolic pelvic and cervical lymph nodes. Excisional biopsy confirmed metastatic prostate adenocarcinoma (NKX3.1-positive). The patient received first-line androgen deprivation therapy with an LH-RH analog and apalutamide, achieving a sustained biochemical response. He remained alive and on treatment with undetectable PSA 3 years later, at the age of 74.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of prostate cancer in MTs and the need to consider metastatic disease in atypical presentations, especially when MMR deficiency is suspected.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1067-1073"},"PeriodicalIF":0.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Probable Case of Cerebral Amyloid Angiopathy-Related Inflammation Temporally Associated with Abemaciclib: A Case Report.","authors":"Jacqueline A C Goos, Aarnout S Plaisier, Astrid A van Gemeren","doi":"10.1159/000553177","DOIUrl":"10.1159/000553177","url":null,"abstract":"<p><strong>Introduction: </strong>Abemaciclib, a cyclin-dependent kinase 4/6 inhibitor that has the ability to penetrate breast tissue and the blood-brain barrier, has been used as an addition to endocrine therapy in breast cancer. Adverse effects like infections, nausea and vomiting, diarrhoea, fatigue, cytopenia (including neutropenia) have been mentioned quite frequently.</p><p><strong>Case presentation: </strong>Here, we present the first report of a possible temporal association in a patient who has been treated with abemaciclib due to an unresectable breast carcinoma and developed cerebral amyloid angiopathy-related inflammation (CAA-ri). Two months after start of treatment with abemaciclib, progressive cognitive impairment was seen (with dyscalculia, behavioural changes, apraxia, and eventually bradyphrenia). Although abemaciclib dosage was reduced and eventually discontinued, the patient experienced three tonic-clonic seizures a week later and was unresponsive afterwards. A CT scan and a subsequent MRI scan showed the imaging characteristics of probable CAA-ri. Furthermore, alternative diagnoses were excluded, and after immunosuppressive therapy, clinical and radiological improvement occurred.</p><p><strong>Conclusion: </strong>Considering this clinical course, a temporal association with abemaciclib has been proposed.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1156-1166"},"PeriodicalIF":0.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Advanced Gastric Cancer Revealed by Intraosseous Mandibular Metastasis: A Case Report.","authors":"Yudai Shimojukkoku, Jun Sumino, Miki Katsurano, Kunihiro Yoshida, Hiroki Masuda, Ayataka Ishikawa, Hiroaki Kanda, Takako Yoshii, Shigeo Tanaka, Kazuhiro Yagihara","doi":"10.1159/000552860","DOIUrl":"10.1159/000552860","url":null,"abstract":"<p><strong>Introduction: </strong>Metastases to oral and maxillofacial regions are uncommon and may mimic odontogenic infection or primary intraosseous malignancy. Mandibular involvement in patients with gastric cancer is particularly rare, and delayed recognition may postpone definitive diagnosis.</p><p><strong>Case presentation: </strong>A 61-year-old man presented with numb-chin syndrome and a nonhealing mandibular extraction socket. Panoramic radiography and CT revealed an ill-defined osteolytic lesion in the left mandible with suspected extraosseous extension. Although primary intraosseous carcinoma was initially suspected, histopathological reevaluation of the mandibular biopsy specimen suggested metastatic adenocarcinoma. 18F-FDG PET/CT demonstrated uptake in the mandible and a suspected primary lesion extending from the lower thoracic esophagus to the stomach, with multiple nodal and distant metastases. Upper gastrointestinal endoscopy revealed an ulcerated, bleeding mass at the gastroesophageal junction, and biopsy demonstrated adenocarcinoma. Based on the combined clinicopathologic, radiologic, and endoscopic findings, the lesion was diagnosed as mandibular metastasis from an advanced upper gastrointestinal adenocarcinoma, clinically managed as gastric cancer. The patient received four cycles of FOLFOX chemotherapy and achieved a partial radiologic response, but treatment was discontinued because of gastrointestinal perforation. He was transitioned to best supportive care and died 7 months after the initial diagnosis.</p><p><strong>Conclusion: </strong>Metastatic disease should be considered for patients with ill-defined mandibular osteolysis accompanied by numb-chin syndrome and a nonhealing extraction socket, even in cases without a history of malignancy. To avoid diagnostic delay, early tissue diagnosis and prompt systemic evaluation are critical.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1122-1129"},"PeriodicalIF":0.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early-Onset Direct Antiglobulin Test-Negative Autoimmune Hemolytic Anemia Induced by Pembrolizumab in Perioperative Triple-Negative Breast Cancer: A Case Report.","authors":"Ryohei Fujii, Nobuhiro Shibata, Yuichiro Kikawa, Shinya Fujita, Yuri Noda, Mikiko Kasahara, Chie Hirai, Manami Tada, Hirotsugu Yanai, Tomoharu Sugie, Masahiro Takada","doi":"10.1159/000552991","DOIUrl":"10.1159/000552991","url":null,"abstract":"<p><strong>Introduction: </strong>Hematological immune-related adverse events associated with immune checkpoint inhibitors (ICIs) are rare, and autoimmune hemolytic anemia (AIHA) is particularly uncommon.</p><p><strong>Case presentation: </strong>A 71-year-old woman with stage IIA triple-negative breast cancer received perioperative pembrolizumab with carboplatin and paclitaxel. During the first treatment cycle, she developed acute severe anemia with laboratory findings consistent with hemolysis. Despite a negative direct antiglobulin test (DAT), major alternative causes of hemolysis were considered unlikely, leading to a clinical diagnosis of suspected ICI-associated AIHA. Oral prednisolone (1 mg/kg) promptly resolved hemolysis without recurrence. Pembrolizumab was discontinued; however, imaging demonstrated a clinical complete response, and subsequent surgery confirmed a pathological complete response (pCR).</p><p><strong>Conclusion: </strong>This case demonstrates that AIHA during ICI therapy may occur despite a negative DAT and underscores the importance of prompt recognition and corticosteroid therapy. Favorable oncologic outcomes, including pCR, may still be achieved despite early discontinuation of ICI therapy.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1100-1107"},"PeriodicalIF":0.7,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural History of Phosphoglyceride Crystal Deposition Disease of the Rib on Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography: A Case Report.","authors":"Kazuhiro Kitajima, Hiroshi Kodama, Mai Nakanishi, Takashi Yamasaki, Takako Kihara, Akifumi Nakamura, Masaki Hashimoto, Chisato Ohe, Soichiro Funaki, Koichiro Yamakado","doi":"10.1159/000553174","DOIUrl":"10.1159/000553174","url":null,"abstract":"<p><strong>Introduction: </strong>Phosphoglyceride crystal deposition disease (PCDD) is characterized by the deposition of phosphoglyceride crystals in the soft tissue or bone, forming tumor-like structures.</p><p><strong>Case presentation: </strong>Herein, we report a case of slow-growing PCDD of the rib followed for 11 years in a 84-year-old man who had received the surgery for lung cancer. The diagnosis was based on computed tomography (CT)-guided needle biopsy. Initial fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) conducted in 2015 showed no apparent abnormal findings in the left third rib bone. FDG-PET/CT in 2018 revealed an expansive, lytic lesion measuring 9 mm in long size in the left third rib posterior arc with weak FDG uptake (maximum standardized uptake value [SUVmax] of 2.72). In the past 8 years, the mass increased to 24 mm with increasing of FDG uptake (SUVmax of 13.35), and did not show any findings such as cortical breakthrough, peritoneal reaction, soft tissue component, or pathological fracture.</p><p><strong>Conclusion: </strong>We should keep this rare disease which shows slow-growing in mind.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1081-1086"},"PeriodicalIF":0.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Successful Multimodal Treatment for High-Grade Serous Ovarian Cancer with <i>BRCA2</i> Heterozygous Deletion with Multiple Recurrences: A Case Report.","authors":"Hsiao-Han Chu, Feng-Yuan Liu, Chun-Chieh Wang, Mei-Chun Lin, Chyong-Huey Lai","doi":"10.1159/000553170","DOIUrl":"10.1159/000553170","url":null,"abstract":"<p><strong>Introduction: </strong>Management of recurrent high-grade serous ovarian cancer (HGSOC) remains a challenge. This case presents a successful multimodal treatment plan in a <i>BRCA</i>-mutated patient with repeated recurrences.</p><p><strong>Case presentation: </strong>A 60-year-old woman diagnosed with FIGO stage III HGSOC received initial debulking surgery followed by chemotherapy at another hospital in December 2017. The patient presented to our institution in March 2019 for further management because of a suboptimal response to 2nd-line chemotherapy. A disseminated disease extent was identified. She progressed (new bone metastasis) during the 3rd- to 5th-line platinum-based chemotherapy, but achieved complete remission after changing to pembrolizumab and weekly paclitaxel. She had a 3rd relapse at the anterior mediastinum (proven by thoracoscopic resection in April 2020, and the tumor was found to harbor a <i>BRCA2</i> heterozygous deletion), which was controlled by adjuvant radiotherapy combined with nivolumab and nab-paclitaxel, followed by maintenance therapy nivolumab plus olaparib, and eventually olaparib monotherapy. A 4th recurrence at the perigastric lymph nodes was found through periodic positron emission tomography surveillance with normal CA-125 in September 2021. Resection of metastasis and hyperthermic intraperitoneal chemotherapy (HIPEC) were performed, and maintenance therapy was again with olaparib. She has maintained remission since then.</p><p><strong>Conclusion: </strong>A durable remission is possible by multimodality management, including the strategic use of chemo-immunotherapy, localized resection plus HIPEC/adjuvant radiotherapy, and poly (ADP-ribose) polymerase (PARP) inhibitor maintenance, in <i>BRCA</i>m-HGSOC with multiple recurrences.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1108-1114"},"PeriodicalIF":0.7,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytokine Release Syndrome Induced by Neoadjuvant Pembrolizumab in Early Triple-Negative Breast Cancer: A Case Report with Implications for Early Diagnosis and Management.","authors":"Hiroki Haneda, Tomohiro Oshino, Hinata Mori, Rumi Niwa, Karin Shikishima, Dong Li, Yumi Moriya, Sayuri Kuwahara, Nana Yoshida, Mitsuchika Hosoda, Masato Takahashi","doi":"10.1159/000553089","DOIUrl":"10.1159/000553089","url":null,"abstract":"<p><strong>Introduction: </strong>Cytokine release syndrome (CRS) is a rare but potentially severe immune-related adverse event associated with immune checkpoint inhibitor (ICI) therapy. CRS is characterized by high fever, hemodynamic instability, and potential multi-organ dysfunction. Pembrolizumab, an ICI, is increasingly used as a standard perioperative treatment for triple-negative breast cancer (TNBC). However, reports of CRS in TNBC remain scarce.</p><p><strong>Case presentation: </strong>We report the case of a 63-year-old woman diagnosed with TNBC (T3N2M0, Stage IIIA) who received pembrolizumab plus chemotherapy. On day 1 of the third cycle, she developed a high fever and headache within hours of pembrolizumab administration. On day 2, hypotension, tachypnea, hypoxia, and hepatic and renal dysfunction were observed. Suspecting CRS, the patient was admitted to the intensive care unit (ICU) and treated with tocilizumab and steroid pulse therapy, resulting in rapid clinical improvement. On day 4, the patient was discharged from the ICU. She was started on oral prednisolone with gradual tapering; however, she experienced CRS recurrence. The patient underwent surgery rather than resuming chemotherapy. At 20 months postoperatively, neither breast cancer relapse nor CRS recurrence was observed.</p><p><strong>Conclusion: </strong>Early diagnosis and treatment of CRS are crucial to prevent severe multi-organ failure.</p>","PeriodicalId":9625,"journal":{"name":"Case Reports in Oncology","volume":"19 1","pages":"1186-1195"},"PeriodicalIF":0.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}