Pituitary enlargement following ipilimumab without long term endocrine dysfunction

Edson Nogueira; Arjun Menon; Anastasia Dede; Indu Mitra; Cathryn Brock; James Larkin; Daniel Morganstein

doi:10.1016/j.currproblcancer.2021.100710

Pituitary enlargement following ipilimumab without long term endocrine dysfunction

Curr Probl Cancer. 2021 Dec;45(6):100710. doi: 10.1016/j.currproblcancer.2021.100710. Epub 2021 Feb 10.

Authors

Edson Nogueira¹, Arjun Menon¹, Anastasia Dede¹, Indu Mitra², Cathryn Brock³, James Larkin⁴, Daniel Morganstein⁵

Affiliations

¹ Department of Endocrinology, Chelsea and Westminster NHS Foundation Trust, London, UK.
² Imaging Department, Chelsea and Westminster NHS Foundation Trust, London, UK.
³ Department of Medical Oncology, Chelsea and Westminster NHS Foundation Trust, London, UK.
⁴ Skin Unit, Royal Marsden NHS Foundation Trust, London, UK.
⁵ Department of Endocrinology, Chelsea and Westminster NHS Foundation Trust, London, UK; Skin Unit, Royal Marsden NHS Foundation Trust, London, UK; Correspondence to: DL Morganstein, Department of Endocrinology, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK. Electronic address: d.morganstein@ic.ac.uk.

PMID: 33622518
DOI: 10.1016/j.currproblcancer.2021.100710

Abstract

Ipilimumab, a monoclonal antibody against CTLA-4, is used in the treatment of melanoma and renal cell cancer. Hypophysitis is one of the more common adverse events, usually presenting with headache, pituitary enlargement and hypopituitarism, mostly ACTH deficiency, which is usually permanent. We describe a series of 3 cases developing pituitary enlargement in keeping with hypophysitis after ipilimumab without any long-term pituitary hormone deficiencies. This illustrates that a comprehensive endocrine assessment is required even when pituitary enlargement is present.

Keywords: Hypophysitis; Hypopituitarism; Ipilimumab; Melanoma.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Antibodies, Monoclonal / adverse effects
Antineoplastic Agents, Immunological / adverse effects*
Antineoplastic Agents, Immunological / therapeutic use*
Female
Glucocorticoids / therapeutic use
Humans
Hypophysitis / chemically induced*
Hypophysitis / drug therapy
Ipilimumab / adverse effects*
Ipilimumab / therapeutic use*
Male
Melanoma / diagnostic imaging
Melanoma / drug therapy*
Middle Aged
Pituitary Diseases / chemically induced
Prednisolone / therapeutic use

Substances

Antibodies, Monoclonal
Antineoplastic Agents, Immunological
Glucocorticoids
Ipilimumab
Prednisolone

Grants and funding

C50947/A18176/CRUK_/Cancer Research UK/United Kingdom