2018 Volume 33 Issue 1 Pages 17-21
A 53-year-old woman underwent surgical treatment for left femoral malignant melanoma, pT4aN2aM0 stage IIIA, with a tumor thickness of 12 mm, and postoperative follow-up observation was performed. Since pulmonary metastasis appeared 5 months after surgery, 3 courses of treatment with dacarbazine (DTIC) were administered, but no effect was observed, and the treatment was changed to nivolumub. After initiation of administration, shrinkage of the temporary lung metastatic lesion was observed ; however, this was followed by exacerbation and multiple subcutaneous metastases were confirmed. Therefore, the treatment was changed to ipilimumab. She developed a severe eating disorder after four administrations of ipilimumub, and upper gastrointestinal endoscopy was performed. As a result, the condition of acute gastritis was confirmed ; a steroid internal dose of 20 mg/day was initiated and the symptoms improved promptly. Through this case, it was elucidated that when administering an immune checkpoint inhibitor treatment, it is necessary to consider the possibility of mucosal damage, not only in the colon, but also in the upper gastrointestinal tract.[Skin Cancer (Japan) 2018 ; 33 : 17-21]
