Session: SUN 163-194-Pituitary Disorders & Case Reports
Poster Board SUN-171
Clinical Case 1: A 60 year old female was diagnosed with MM in July 2011. 4 cycles of IPI were given, ending in March 2012. In July 2012 she developed severe hyponatremia and was diagnosed with central adrenal insufficiency. Remainder of pituitary labs and MRI of head were unremarkable. She was started on hydrocortisone replacement therapy. Her most recent melanoma evaluation in Sep 2012 had evidence of delayed response in her lung nodules. Repeat testing showed persistent adrenal insufficiency.
2. A 71 year old male was diagnosed with melanoma recurrence in May 2012. 4 cycles of IPI were given, ending in July 2012. Two weeks after getting IPI he developed proximal muscle weakness and fatigue. MRI of the head showed hypophysitis. Pituitary labs showed hypopituitarism with thyroid, gonadotropin and ACTH abnormalities. His most recent evaluation in Dec 2012 had almost complete resolution of disease. He remains on hydrocortisone, thyroid and testosterone replacement therapy.
3. A 74 year old male was diagnosed with MM in Dec 2011. 4 cycles of IPI were given , ending in April 2012. Shortly after, he developed headaches and fatigue. MRI of the head showed hypophysitis. Pituitary labs showed hypopituitarism with thyroid, gonadotropin and ACTH abnormalities. He is on hydrocortisone, thyroid and testosterone replacement therapy. Currently he is being treated with temozolomide.
Conclusion: The enhanced immunity with IPI appears to frequently target the anterior pituitary gland. Evaluation of pituitary gland function should be considered with IPI therapy. It is unknown if IPI induced hypophysitis is reversible.
Nothing to Disclose: MKA, VR, YS, MA, DBD
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