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European Archives of Oto-Rhino-Laryngology

Erschienen in:

03.02.2024 | Case Report

Aortic rupture following acute aortitis in a patient with head and neck carcinoma treated with nivolumab: a rare but severe immune-related adverse event

verfasst von: Yuki Ohno, Yushi Ueki, Shusuke Oshima, Jo Omata, Yusuke Yokoyama, Takeshi Takahashi, Ryusuke Shodo, Keisuke Yamazaki, Arata Horii

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 4/2024

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Abstract

Introduction

Immune-related adverse events (irAEs) due to immune checkpoint inhibitors may lead to discontinuation and treatment-related death. Acute aortitis is a rare but severe irAE.

Case presentation

A 67-year-old man with recurrent lower gingival carcinoma received nivolumab therapy. Twenty-three months later, he experienced chest compression, which resulted in syncope. Following a whole-body computed tomography (CT) scanning, which revealed diffuse thickening of the aorta, and systemic assessments of the causes of aortitis, he was diagnosed with acute aortitis due to irAE. Nivolumab discontinuation and oral steroids improved CT findings. However, 11 months after nivolumab discontinuation, he developed an aortic aneurysmal rupture. Endovascular aortic repair rescued him. A durable anti-cancer response was still observed 4 months after the aortic rupture.

Conclusion

Although severe irAE, such as acute aortitis, occurred, the patient may still achieve a durable response. A broad examination and prompt treatment of irAE can help improve the patient’s survival.

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Titel: Aortic rupture following acute aortitis in a patient with head and neck carcinoma treated with nivolumab: a rare but severe immune-related adverse event
verfasst von: Yuki Ohno
Yushi Ueki
Shusuke Oshima
Jo Omata
Yusuke Yokoyama
Takeshi Takahashi
Ryusuke Shodo
Keisuke Yamazaki
Arata Horii
Publikationsdatum: 03.02.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 4/2024
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-024-08495-2

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Aortic rupture following acute aortitis in a patient with head and neck carcinoma treated with nivolumab: a rare but severe immune-related adverse event