Atezolizumab-induced Encephalitis in a Patient with Hepatocellular Carcinoma: A Case Report and Literature Review |
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| Authors: | Tomoyuki Satake Yuta Maruki Yuko Kubo Masamichi Takahashi Akihiro Ohba Yoshikuni Nagashio Shunsuke Kondo Susumu Hijioka Chigusa Morizane Hideki Ueno Takuji Okusaka |
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| Affiliation: | 1.Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan; 2.Department of Diagnostic Radiology, National Cancer Center Hospital, Japan; 3.Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Japan |
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| Abstract: | We herein report a case of encephalitis in a 42-year-old woman with hepatocellular carcinoma following atezolizumab plus bevacizumab therapy. After two weeks of treatment, she was admitted for a high fever, impaired consciousness, and convulsive seizure refractory to diazepam. Magnetic resonance imaging revealed a hyperintense splenial lesion. A cerebrospinal fluid test excluded malignancy and infection. These findings were highly suggestive of a diagnosis of encephalitis due to atezolizumab, an immune-related adverse event. Steroid pulse therapy improved the fever and seizure. However, her incomplete right-sided paralysis and aphasia persisted. This is the first case report of encephalitis caused by atezolizumab plus bevacizumab therapy for hepatocellular carcinoma. |
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| Keywords: | hepatocellular carcinoma immune-related adverse events encephalitis atezolizumab plus bevacizumab mild encephalitis/encephalopathy with a reversible splenial lesion |
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