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Vol.63 No.7 contents | Japanese/English |
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- Case Report -
A Case of Pulmonary Adenocarcinoma Complicated with Systemic Sclerosis
Kei Takahashi1, Taichi Takashina1, Masahiro Watanabe1, Akira Kamimura1, Shigeaki Ogura11Department of Internal Medicine, Iwamizawa municipal General Hospital, Japan
Background. There are few reports on the efficacy and safety of immune checkpoint inhibiter (ICI) in patients with autoimmune diseases. Irradiation for systemic sclerosis patients has been reported to cause late adverse events and is not a favorable indication. We herein report a case of pulmonary adenocarcinoma complicated with systemic sclerosis in which chemotherapy combined with an ICI was successful, allowing radiotherapy to be avoided. Case. A 67-year-old man had been diagnosed with systemic sclerosis at 55 years old and been under treatment at another hospital. He was referred to our hospital, when he has had a complaint of a back pain and was noted abnormalities on his CT scan. After a close examination, he was diagnosed with pulmonary adenocarcinoma that metastasized to the thoracic vertebrae. The metastasis in the vertebrae extended into the spinal canal, but the patient had systemic sclerosis, so irradiation carried a high risk. Because the tumor expressed high PD-L1, chemotherapy with an ICI was finally selected. Both the primary tumor and metastasis in the thoracic vertebrae were remarkably reduced without serious adverse events. Conclusion. ICI administration to systemic sclerosis patients may be a treatment option. However, cautious consideration is required, as this approach may increase the frequency of exacerbation of preexisting disease and immune-related adverse events.
key words: Systemic sclerosis, Pulmonary adenocarcinoma, Radiation therapy, PD-L1, Immune checkpoint inhibitor
Received: March 30, 2023
Accepted: July 14, 2023
JJLC 63 (7): 953-958, 2023
