Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract

Urothelial carcinomas of the upper urinary tract (UTUC) are relatively rare and challenging to treat. We present a case report of a 55-year-old male patient with high-grade renal UTUC who received adjuvant pembrolizumab immunotherapy. The patient developed retroperitoneal fibrosis as an immune-relat...

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Main Authors: L. Gallardo Zamora, F.C. von Rundstedt, C. Wach, W.P. Fendler, I. Maric, K. Herrmann, J.T. Siveke, P.F.-Y. Cheung, V. Grünwald
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Urology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214442025001767
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author L. Gallardo Zamora
F.C. von Rundstedt
C. Wach
W.P. Fendler
I. Maric
K. Herrmann
J.T. Siveke
P.F.-Y. Cheung
V. Grünwald
author_facet L. Gallardo Zamora
F.C. von Rundstedt
C. Wach
W.P. Fendler
I. Maric
K. Herrmann
J.T. Siveke
P.F.-Y. Cheung
V. Grünwald
author_sort L. Gallardo Zamora
collection DOAJ
description Urothelial carcinomas of the upper urinary tract (UTUC) are relatively rare and challenging to treat. We present a case report of a 55-year-old male patient with high-grade renal UTUC who received adjuvant pembrolizumab immunotherapy. The patient developed retroperitoneal fibrosis as an immune-related adverse event (irAE) following treatment.To better understand the extent of fibrosis, we utilized 68Ga FAPI-46 PET/CT imaging, a radioligand that binds to fibroblast activation protein alpha expressed on activated fibroblasts. The imaging pattern correlated with histopathological findings of fibrotic tissue.This case highlights the limited experience with rare irAEs due to checkpoint inhibitors, such as retroperitoneal fibrosis.
format Article
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institution Kabale University
issn 2214-4420
language English
publishDate 2025-07-01
publisher Elsevier
record_format Article
series Urology Case Reports
spelling doaj-art-7c5f91be12314b8bb49bc85d42ddd67f2025-08-20T03:56:45ZengElsevierUrology Case Reports2214-44202025-07-016110310510.1016/j.eucr.2025.103105Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tractL. Gallardo Zamora0F.C. von Rundstedt1C. Wach2W.P. Fendler3I. Maric4K. Herrmann5J.T. Siveke6P.F.-Y. Cheung7V. Grünwald8Universitätsklinikum Wuppertal, Wuppertal, Germany; Corresponding author. Department of Urology, Helios University Hospital Wuppertal, Witten/Herdecke University, Heusnerstrasse 40, 42283, Wuppertal, Germany.Universitätsklinikum Wuppertal, Wuppertal, GermanyUniversitätsklinikum Wuppertal, Wuppertal, GermanyUniversitätsklinikum Essen, Essen, GermanyUniversitätsklinikum Essen, Essen, GermanyUniversitätsklinikum Essen, Essen, GermanyUniversitätsklinikum Essen, Essen, GermanyUniversitätsklinikum Essen, Essen, GermanyUniversitätsklinikum Essen, Essen, GermanyUrothelial carcinomas of the upper urinary tract (UTUC) are relatively rare and challenging to treat. We present a case report of a 55-year-old male patient with high-grade renal UTUC who received adjuvant pembrolizumab immunotherapy. The patient developed retroperitoneal fibrosis as an immune-related adverse event (irAE) following treatment.To better understand the extent of fibrosis, we utilized 68Ga FAPI-46 PET/CT imaging, a radioligand that binds to fibroblast activation protein alpha expressed on activated fibroblasts. The imaging pattern correlated with histopathological findings of fibrotic tissue.This case highlights the limited experience with rare irAEs due to checkpoint inhibitors, such as retroperitoneal fibrosis.http://www.sciencedirect.com/science/article/pii/S2214442025001767Urothelial carcinomaUpper urinary tractRetroperitoneal fibrosisImmune-related adverse eventPembrolizumab68Ga FAPI-46 PET/CT
spellingShingle L. Gallardo Zamora
F.C. von Rundstedt
C. Wach
W.P. Fendler
I. Maric
K. Herrmann
J.T. Siveke
P.F.-Y. Cheung
V. Grünwald
Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
Urology Case Reports
Urothelial carcinoma
Upper urinary tract
Retroperitoneal fibrosis
Immune-related adverse event
Pembrolizumab
68Ga FAPI-46 PET/CT
title Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
title_full Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
title_fullStr Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
title_full_unstemmed Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
title_short Fibroblast-directed PET imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
title_sort fibroblast directed pet imaging reveals a case of retroperitoneal fibrosis after immunotherapy for metastatic urothelial cancer of the upper tract
topic Urothelial carcinoma
Upper urinary tract
Retroperitoneal fibrosis
Immune-related adverse event
Pembrolizumab
68Ga FAPI-46 PET/CT
url http://www.sciencedirect.com/science/article/pii/S2214442025001767
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