A case of simultaneous double cancer of oral malignant melanoma and lung adenocarcinoma with nivolumab-induced destructive thyroiditis

Abstract

Nivolumab has various immune-related adverse events, including thyroid dysfunction. We describe a case of maxillary gingival malignant melanoma and lung adenocarcinoma with destructive thyroiditis after administration of nivolumab in a 62-year-old man who received multidisciplinary treatment with heavy particle therapy, surgical therapy, and immunotherapy. When destructive thyroiditis appeared, there were no symptoms but TSH decreased and FT3, FT4 increased in the hematology values. Nivolumab treatment was therefore discontinued in cooperation with endocrinologists. Without thyrotoxicosis, thyroid function normalized two months after discontinuing nivolumab. There has been a continuous cytoreductive effect on maxillary gingival malignant melanoma, and 29 months have passed since the start of treatment, but no metastasis has been observed.