Sarmiento IF, Vieyra HP, Alatorre AJ, Rubalcava OJ, Tejeda MJ, Steta OJ

Language: Spanish
References: 22
Page: 681-687
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ABSTRACT

Background: There is a small number of case reports describing hypopituitarism associated with hypothalamic and hypophyseal metastasis from small cell lung carcinoma. Therefore, their identification represents a diagnostic challenge. Endocrinologic dysfunction caused by anti-PDL1 immunotherapy is an important differential diagnosis.
Clinical case: A 68-year-old male patient with pulmonary small cell lung carcinoma and extensive disease, who received chemotherapy (etoposide and cisplatin) and immunotherapy with atezolizumab with excellent response to treatment, presented to the emergency ward eleven months after the beginning of treatment with worsening functional status, fluctuating level of consciousness and attention, bradypsychia and generalized weakness.
Conclusions: Endocrinologic disorders from tertiary origin are uncommon. The differential diagnosis is complex and every axis must be appropriately evaluated, especially when patients are receiving treatment with immunotherapy. It is imperative to perform an adequate correlation between the clinical scenario and biochemical and imaging studies.

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