Acute inflammatory thyromegaly following checkpoint inhibition: A new imaging entity?

Middlebrooks, Erik H.; Westbrook, Brian C.; Conry, Robert M.

doi:10.1016/j.radcr.2017.09.008

Cited by 6 publications

(6 citation statements)

References 2 publications

(4 reference statements)

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“…Neck CT can also reveal abnormalities of thyroiditis such as diffuse enlargement of the gland with hypoattenuation and occasional areas of ring enhancement from gland necrosis. Once the active phase of the disease has resolved gland atrophy and subsequent hypothyroidism can develop with CT and PET/CT findings reflective of this [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…TFTs should be part of baseline laboratory testing in all patients undergoing treatment with immunotherapies and should be regularly monitored. However, interpretation should be undertaken with caution as numerous factors may affect the hypothalamic-pituitary-thyroid axis in cancer patients (such as steroids, non-thyroid illnesses and iodinated contrast injection) [7].…”

Section: Discussionmentioning

confidence: 99%

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A case of immunotherapy-induced thyroiditis

Pears,

Mahajan,

Olsson-Brown

et al. 2024

Exploration of Targeted Anti-Tumor Therapy

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Immunotherapy treatments for cancer are known to cause adverse thyroid events which present a diagnostic challenge to clinicians and radiologists. This case report highlights the importance of a high clinical index of suspicion and careful assessment of the thyroid on serial imaging studies to make the diagnosis. The case involves a 65-year-old male with malignant melanoma who was started on immunotherapy as part of a clinical trial. He developed thyroid dysfunction followed by an attack of acute neck pain. Ultrasound of his thyroid was performed which showed significant atrophy. A review of previous imaging was undertaken which confirmed the patient had suffered from thyroiditis and subsequent atrophy. Following this, the diagnosis of immunotherapy-induced thyroid dysfunction was made. Thyroxine supplementation and steroid dose were then adjusted causing his thyroid function and symptoms to improve. Immunotherapy agents for cancers are becoming more and more common. As the case report shows, physicians and radiologists will need to be vigilant to diagnose and treat any adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case of immunotherapy-induced thyroiditis

Pears,

Mahajan,

Olsson-Brown

et al. 2024

Exploration of Targeted Anti-Tumor Therapy

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“…Previous studies on thyroid irAE due to nivolumab investigated thyroid hormone levels only, and a few articles mentioned imaging findings including changes in the thyroid gland volume. [ 7 , 8 ] In the 24 patients who were screened, volumetry analysis revealed a >0.1 thyroid volume changes ratio (range: 0.79 to 1.32) in nine patients (37.5%), including those with and without thyroid dysfunction. This prevalence of thyroid volume change was slightly higher than that of thyroid dysfunction in previous reports (11.7-33.5%).…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] However, only a few articles reported qualitative or quantitative imaging findings including the volume changes of the thyroid gland during nivolumab therapy. [ 7 , 8 ] Similarly, tyrosine kinase inhibitors induce thyroid dysfunction and atrophy in the thyroid, [ 9 ] and nivolumab causes changes in the thyroid gland volume. [ 7 , 8 ] We reported CT imaging findings of nivolumab-induced thyroid dysfunction and frequency in this case series.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography imaging findings of nivolumab-induced thyroid dysfunction

Oki

Inoue

Nagatani

et al. 2022

JCIS

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The thyroid gland is most frequently involved in immune-related adverse events (irAEs) by nivolumab. We reviewed the thyroid function and thyroid gland volume and volume change ratio between baseline and follow-up CT (volume follow-up/volume baseline) in 24 patients treated with nivolumab for lung cancer and renal cell carcinoma. Among them, four (16.7%) demonstrated nivolumab-induced thyroid dysfunction that shows either hypothyroidism or hyperthyroidism. Three and one cases were treated with nivolumab for lung cancer and renal cell carcinoma, respectively. Two patients with hypothyroidism (cases 1 and 2) showed reduced thyroid volume (volume change ratio: 0.80 and 0.84) on computed tomography (CT) images. Besides, remarkably diminished CT attenuation of the thyroid gland was observed in a patient with hypothyroidism (case 2). One of the two patients with hyperthyroidism showed increased thyroid volume (volume change ratio: 1.32) (case 3), whereas no difference in the thyroid gland volume was observed between the previous and follow-up CT in another patient with hyperthyroidism (case 4). Thyroid volume change ratio >0.1 was observed even in 6 of 20 (30%) patients without thyroid dysfunction. Considering the wide use of nivolumab in cancer treatment, radiologists should be aware that changes in the thyroid volume and attenuation on CT are associated with thyroid dysfunction caused by nivolumab, as well as thyroid volume may change even in patients with normal thyroid function during nivolumab therapy.

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Ipilimumab/nivolumab

2018

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Acute inflammatory thyromegaly following checkpoint inhibition: A new imaging entity?

Cited by 6 publications

References 2 publications

A case of immunotherapy-induced thyroiditis

A case of immunotherapy-induced thyroiditis

Computed tomography imaging findings of nivolumab-induced thyroid dysfunction

Ipilimumab/nivolumab

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