Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma

ABSTRACT Introduction Immune checkpoint inhibitors (ICIs) are useful in the treatment of metastatic renal cell carcinoma. ICIs have been associated with a variety of immune‐related adverse events (irAEs), one of which is a sarcoid‐like reaction (SLR). SLR is often difficult to distinguish from cance...

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Main Authors: Kanta Fukushima, Sota Mizukoshi, Tomohiro Ino, Takuya Ishida, Yumika Ito, Akira Okimura, Munehide Nakatsugawa, Takeshi Hashimoto
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:IJU Case Reports
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Online Access:https://doi.org/10.1002/iju5.70027
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author Kanta Fukushima
Sota Mizukoshi
Tomohiro Ino
Takuya Ishida
Yumika Ito
Akira Okimura
Munehide Nakatsugawa
Takeshi Hashimoto
author_facet Kanta Fukushima
Sota Mizukoshi
Tomohiro Ino
Takuya Ishida
Yumika Ito
Akira Okimura
Munehide Nakatsugawa
Takeshi Hashimoto
author_sort Kanta Fukushima
collection DOAJ
description ABSTRACT Introduction Immune checkpoint inhibitors (ICIs) are useful in the treatment of metastatic renal cell carcinoma. ICIs have been associated with a variety of immune‐related adverse events (irAEs), one of which is a sarcoid‐like reaction (SLR). SLR is often difficult to distinguish from cancer progression. Case Presentation The patient is a 71‐year‐old woman. She underwent laparoscopic nephrectomy after 4 courses of ipilimumab + nivolumab therapy for clear cell renal cell carcinoma with femoral bone metastasis. In the pathological examination, in addition to tumor‐infiltrating lymphocytes, numerous non‐caseating epithelioid cell granulomas were found in the tumor. The occurrence of non‐caseating epithelioid cell granuloma in a patient who did not meet the diagnostic criteria for systemic sarcoidosis was considered SLR due to ICI. Conclusions We report the first case of a patient who underwent surgery for metastatic renal cell carcinoma after treatment with ICI and who was pathologically diagnosed with SLR in the kidney.
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issn 2577-171X
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publishDate 2025-05-01
publisher Wiley
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spelling doaj-art-bff80ec0b98541f68022e75d544ea1592025-08-20T02:14:49ZengWileyIJU Case Reports2577-171X2025-05-018328528810.1002/iju5.70027Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell CarcinomaKanta Fukushima0Sota Mizukoshi1Tomohiro Ino2Takuya Ishida3Yumika Ito4Akira Okimura5Munehide Nakatsugawa6Takeshi Hashimoto7Department of Urology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Urology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Urology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Urology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Diagnostic Pathology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Diagnostic Pathology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Diagnostic Pathology Tokyo Medical University Hachioji Medical Center Tokyo JapanDepartment of Urology Tokyo Medical University Hachioji Medical Center Tokyo JapanABSTRACT Introduction Immune checkpoint inhibitors (ICIs) are useful in the treatment of metastatic renal cell carcinoma. ICIs have been associated with a variety of immune‐related adverse events (irAEs), one of which is a sarcoid‐like reaction (SLR). SLR is often difficult to distinguish from cancer progression. Case Presentation The patient is a 71‐year‐old woman. She underwent laparoscopic nephrectomy after 4 courses of ipilimumab + nivolumab therapy for clear cell renal cell carcinoma with femoral bone metastasis. In the pathological examination, in addition to tumor‐infiltrating lymphocytes, numerous non‐caseating epithelioid cell granulomas were found in the tumor. The occurrence of non‐caseating epithelioid cell granuloma in a patient who did not meet the diagnostic criteria for systemic sarcoidosis was considered SLR due to ICI. Conclusions We report the first case of a patient who underwent surgery for metastatic renal cell carcinoma after treatment with ICI and who was pathologically diagnosed with SLR in the kidney.https://doi.org/10.1002/iju5.70027immune checkpoint inhibitorimmune‐related adverse eventrenal cell carcinomasarcoid‐like reaction
spellingShingle Kanta Fukushima
Sota Mizukoshi
Tomohiro Ino
Takuya Ishida
Yumika Ito
Akira Okimura
Munehide Nakatsugawa
Takeshi Hashimoto
Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
IJU Case Reports
immune checkpoint inhibitor
immune‐related adverse event
renal cell carcinoma
sarcoid‐like reaction
title Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
title_full Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
title_fullStr Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
title_full_unstemmed Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
title_short Sarcoid‐Like Reaction (SLR) Associated With Immune Checkpoint Inhibitors in Metastatic Renal Cell Carcinoma
title_sort sarcoid like reaction slr associated with immune checkpoint inhibitors in metastatic renal cell carcinoma
topic immune checkpoint inhibitor
immune‐related adverse event
renal cell carcinoma
sarcoid‐like reaction
url https://doi.org/10.1002/iju5.70027
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