Drug-associated abdominal aortitis and retroperitoneal fibrosis after treatment with nivolumab

A 60-year-old man with metastatic supraglottic laryngeal cancer treated with nivolumab, an immune checkpoint inhibitor (ICI), developed abdominal aortitis and retroperitoneal fibrosis. The nivolumab was discontinued and no steroids were initiated. A literature search found 19 other cases of ICI-associated aortitis. The evidence is limited and conflicting on the optimal management of these rare but serious adverse events. With increasing application in the treatment of a multitude of cancer types, physicians must remain aware of aortitis as an adverse event and consider the potential risks vs benefits before initiating ICI treatment for their patient.