case_images: PMC7479461_01
case_images: Pembrolizumab monotherapy in a patient with underlying p-ANCA vasculitis describes the stability of this patient's malignancy as well as the stability of her underlying autoimmune vasculitis while on pembrolizumab therapy. (a) displays computerized tomography (CT) images at baseline and on-treatment after 3 cycles of pembrolizumab. The size of the vaginal apex mass and lung nodules remained relatively unchanged. Repeat CT scan of the chest, abdomen, and pelvis revealed a pulmonary nodule (1.0 cm), an enlarged perihilar lymph node (1.4 cm), and a right-sided vaginal apex mass (2.8 cm) causing right-sided hydronephrosis (a). (b) CA-125 tumor marker levels are shown. (c) Serum creatinine level over time (black circles, left axis) and ANCA levels (red squares, right axis) are shown. Time on pembrolizumab is highlighted.
case_images: CRIONM2020-3428945.001.jpg
case_images: PMC7479461_01_CRIONM2020-3428945.001.jpg
case_images: fig1
case_images: She underwent three cycles followed by restaging CT scans which showed stable disease (Figure 1(a)).  Figure 1(c) displays the patient's creatinine levels (black circle, left y-axis) and ANCA (red square, right y-axis) plotted over time. During this treatment period, her renal function was followed closely (Figure 1(c)), and urinalysis was obtained frequently to evaluate for hematuria. She did not develop any signs or symptoms suggestive of a vasculitis flare.  Figure 1(b) displays the patient's CA-125 values over the same time period. Despite her stable CA-125 (Figure 1(b)) and radiographically stable disease (Figure 1(a)), the patient gradually became more socially withdrawn, depressed, and decreased her oral intake despite maximal support from her family and treatment by her psychiatrist.