Severe Superior Vena Cava Syndrome in a Patient With Metastatic Melanoma Receiving Nivolumab: A Case Report
Immune checkpoint inhibitors (ICIs) such as nivolumab have revolutionized cancer therapy, including melanoma. Immune-related events happen in up to 70% of patients. Sarcoid-like reactions are rare and can mimic tumor progression. An 82-year-old man with metastatic melanoma receiving nivolumab for 5...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American College of Physicians
2025-02-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.0851 |
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| Summary: | Immune checkpoint inhibitors (ICIs) such as nivolumab have revolutionized cancer therapy, including melanoma. Immune-related events happen in up to 70% of patients. Sarcoid-like reactions are rare and can mimic tumor progression. An 82-year-old man with metastatic melanoma receiving nivolumab for 5 years presented with dyspnea and neck and face swelling. A computed tomography scan of the chest showed paratracheal adenopathy compressing the superior vena cava (SVC) and pleural effusion. Biopsies revealed only benign lymphocytes. The symptoms resolved with a course of prednisone. This case highlights rare nivolumab-induced lymphoid proliferation causing SVC syndrome. New SVC syndrome symptoms should prompt evaluation to distinguish between cancer progression, infection, and drug-induced lymphadenopathy. |
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| ISSN: | 2767-7664 |