Korean J Gastroenterol.  2023 Jul;82(1):35-39. 10.4166/kjg.2023.054.

A Case of Transverse Myelitis Following Treatment with Atezolizumab for Advanced Hepatocellular Carcinoma

• Kim KH
• Baek YH
• Kang YW
• Yoon BA
• Moon SY

• KMID: 2544938
• DOI: http://doi.org/10.4166/kjg.2023.054

Abstract

The results of the IMbrave150 study have led to widespread use of the combination therapy of atezolizumab and bevacizumab as a first-line treatment for unresectable or metastatic hepatocellular carcinoma (HCC). Compared to traditional cytotoxic chemotherapy agents, immune checkpoint inhibitors show a spectrum of side effects ranging from mild side effects such as skin rash to potentially severe systemic effects such as myocarditis. We present a case of transverse myelitis diagnosed during the treatment of HCC with atezolizumab and bevacizumab combination therapy.

Keyword

Hepatocellular carcinoma; Atezolizumab; Transverse myelitis

Figure

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  Fig. 1 The patient's initial liver dynamic computer tomography shows multiple nodules in both hepatic lobes that demonstrate enhancement in the arterial phase (A, B), and washout in portal phase (C). Tumor thrombosis of the right portal vein is observed (D).

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  Fig. 2 Thoracic MRI findings of the patient. Diffuse spinal cord high signal intensity on T2 weighted sagittal image was observed and there was abnormal contrast enhancement on T1 sagittal image (A, B). On axial image, subtle high signal intensity was observed on T8 level with prominent T1 contrast enhancement (C, D).

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