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Abstract

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Article in Japanese

Case Report

PET-CT useful for diagnosis and evaluation of polymyalgia rheumatica occurring after immune checkpoint inhibitor treatment for lung cancer: a case report

Jiro Nakashioya  Yaya Satozono  Kengo Tanigawa  Tomoko Yagi  Yoichi Dotake  Ikkou Higashimoto 

Respiratory Medicine, Kagoshima City Hospital

ABSTRACT

The patient was a 74-year-old woman. An immune checkpoint inhibitor (pembrolizumab) was administered for recurrence after surgery for lung adenocarcinoma. Although the treatment was effective (partial response), arthralgia and myalgia appeared around 4 months after the treatment started, and her upper limb elevation and walking became impaired. Imaging examination revealed no recurrence of lung cancer or deformation in any joint. However, 18F-fluorodeoxyglucose-positron emission tomography-computed tomography (PET-CT) revealed multiple abnormal accumulations in the bilateral shoulders, hip joints, and lumbar spinous processes. A diagnosis of polymyalgia rheumatica (PMR) was made based on the negative test result for rheumatoid factor and increased blood sedimentation rate. After treatment with corticosteroids was initiated, the pain improved, and PET-CT reexamination 1 year later showed markedly diminishment of the abnormal accumulation in the joints. PMR as an immune-related adverse event is rarely reported. PET-CT was useful for the diagnosis and evaluation of PMR.

KEYWORDS

Lung adenocarcinoma  Immune checkpoint inhibitor  Immune-related adverse event (irAE)  Polymyalgia rheumatica (PMR)  18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG/PET-CT) 

Received 27 Jan 2020 / Accepted 2 Apr 2020

AJRS, 9(4): 289-293, 2020

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