Ipilimumab-induced colonic perforation

Lyle Burdine; Keith Lai; Jonathan A Laryea

doi:10.1093/jscr/rju010

Ipilimumab-induced colonic perforation

J Surg Case Rep. 2014 Mar 5;2014(3):rju010. doi: 10.1093/jscr/rju010.

Authors

Lyle Burdine¹, Keith Lai², Jonathan A Laryea³

Affiliations

¹ Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA ljburdine@uams.edu.
² Department of Pathology, University of Arkansas for Medical Sciences, University of Arkansas, Little Rock, AR, USA.
³ Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Abstract

Biologic immune modulators such as ipilimumab have demonstrated the efficacy against metastatic melanoma. We present a recent case of a 52-year-old male who initially developed mild colitis following the initiation of ipilimumab treatment for metastatic melanoma. Despite initial improvement with immediate cessation of drug and initiation of high-dose steroid therapy his clinical condition worsened and the patient presented to our facility in extremis from colonic perforation. Following an extended right hemicolectomy his postoperative period was extended due to continued symptomatic enteritis. After 3 weeks colonoscopy revealed that the autoimmune event had begun to subside; his condition improved, resulting in discharge. We discuss this particular side effect with respect to ipilimumab adjuvant therapy in melanoma.

Publication types

Case Reports