Pancreatitis as immune-related adverse event during pembrolizumab therapy for multiple lung metastases from renal pelvic cancer.

Introduction: Pembrolizumab administration has become the standard of care for patients with urothelial carcinoma, though a variety of adverse events have been reported. Presented here is a rare case of pancreatitis that occurred as an immune-related adverse event. Case presentation: An 81-year-old man undergoing treatment with pembrolizumab for multiple lung metastases from renal pelvic cancer was presented with a fever and diagnosed with pancreatitis based on elevated pancreatic enzyme levels and imaging findings. There was no history of alcohol consumption or findings indicating gallstones, elevated liver enzymes, or abdominal complications. The patient was diagnosed with immune-related adverse event pancreatitis and treated with Lactate Ringer's solution (3000 mL/day) and steroids, during which his condition improved. Conclusion: Although pancreatitis is a rare complication, it should always be considered as a potential immune-related adverse event in patients treated with an immune checkpoint inhibitor such as pembrolizumab.

A case of Avelumab response to multiple bone and lymph node metastases of plasmacytoid variant bladder cancer.

A 74-year-old man was diagnosed with bladder cancer and referred to our department. For definitive diagnosis, transurethral resection of the bladder tumor(TURBT) was performed. The pathological result showed plasmacytoid variant of urothelial carcinoma. Subsequently, robot-assisted radical cystectomy, lymph node dissection and ileal conduit was performed, but multiple bone metastases and periaortic lymph node metastases newly appeared 30 days later. Gemcitabine and cisplatin (GC) was started, and after 4 courses, the patient became Partial Response (PR), and was switched to Avelumab as maintenance therapy. After about 1 year of maintenance therapy, the patient is still in PR.

A case of renal schwannoma.

The patient was referred to our department from neurosurgery for close examination of a renal mass that had been present in the lower pole of the kidney for approximately 2 year. Retrograde Pyelography and Ureteroscopy showed no obvious neoplastic lesion in the renal pelvis. Therefore, Percutaneous renal tumor biopsy was performed. The pathological result was Schwannoma. The patient was followed up for 1 year after the biopsy. No progression was observed for approximately 3 years after the renal mass was first discovered. Because renal schwannomas are extremely rare, we report this case with a literature review.