Atezolizumab induced immune-related adverse event mimicking conjunctival metastatic disease

Julia Aschauer; Ruth Donner; Jan Lammer; Gerald Schmidinger

doi:10.1016/j.ajoc.2022.101489

Atezolizumab induced immune-related adverse event mimicking conjunctival metastatic disease

Am J Ophthalmol Case Rep. 2022 Mar 16:26:101489. doi: 10.1016/j.ajoc.2022.101489. eCollection 2022 Jun.

Authors

Julia Aschauer¹, Ruth Donner¹, Jan Lammer¹, Gerald Schmidinger¹

Affiliation

¹ Department of Ophthalmology and Optometry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Abstract

Purpose: To describe a case of an immune-related adverse event associated with Atezolizumab therapy which was aggravated by ocular surgery.

Observations: A 59-year-old man treated with Atezolizumab for metastatic non-small-cell lung cancer developed a conjunctival hypertrophic lesion mistaken for metastatic tissue. Biopsy surgery induced fulminant and multifocal granulomatous conjunctival tissue growth and sterile corneal ulceration. The immune-related adverse event was refractory to topical therapy, with curative success only after introduction of systemic prednisone.

Conclusions: Atezolizumab use may be associated with severe and recalcitrant ocular surface inflammation with potential exacerbation after surgical interventions.

Keywords: Atezolizumab; Conjunctival granuloma; Immune-related adverse event; Ocular surface disease; Surgery.

Publication types

Case Reports