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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Bibliographic Details
Main Authors: Hoang Tran Pham, Ravindra Gudavalli, Archan M. Shah, An Ho
Format: Article
Language:English
Published: American College of Physicians 2025-02-01
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.
ISSN:2767-7664