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An Evanishing Thyroid During Immune Checkpoint Inhibitor Therapy
Marco Cuzzocrea1, Gaetano Paone1, Luca Ceriani
1From the Competence Centre for Thyroid Diseases-Clinic for Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale.
Clinical Nuclear Medicine
|October 25, 2021
Summary
Immune checkpoint inhibitors like nivolumab can cause thyroiditis. Serial 18F-FDG PET/CT scans showed thyroid gland involution in a nasopharyngeal carcinoma patient during nivolumab treatment.
Area of Science:
- Oncology
- Endocrinology
- Nuclear Medicine
Background:
- Immune checkpoint inhibitors (ICIs) are increasingly used in cancer therapy.
- Endocrine-related adverse events, particularly thyroid dysfunction, are known side effects of ICIs.
- This case highlights the impact of ICIs on the thyroid gland in a patient with nasopharyngeal carcinoma.
Observation:
- A 37-year-old male with stage IVb nasopharyngeal carcinoma received nivolumab treatment.
- The patient had no prior history of thyroid disease and normal thyroid-stimulating hormone levels before treatment.
- Serial 18F-FDG PET/CT scans were performed during nivolumab therapy.
Findings:
- The 18F-FDG PET/CT studies demonstrated a progressive involution of the thyroid gland.
- This finding is consistent with immune checkpoint inhibitor-induced thyroiditis.
- The thyroid gland showed reduced metabolic activity and size on serial imaging.
Implications:
- FDG PET/CT can visualize structural and functional changes in the thyroid gland during ICI therapy.
- Understanding these imaging findings is crucial for managing ICI-related endocrine toxicities.
- This case underscores the importance of monitoring thyroid function and morphology in patients receiving ICIs.
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