クリゾチニブ内服中の肺癌患者に発生した腎膿瘍の1例

A 51-year-old female patient developed multiple crizotinib- associated renal abscesses in her left kidney. She noticed a swelling of the right supraclavicular node in June, 202X. She visited a clinic and a blood test showed an elevated carcinoembryonic antigen. She was referred to our hospital and underwent computed tomography (CT) which revealed nodules in her right lung, mediastinum, and right supraclavicular lymph node. After thorough examination, the patient was diagnosed with metastatic lung adenocarcinoma. She had a ROS-1 gene mutation; thus, treatment with crizotinib was recommended. Alter the initiation of crizotinib in October,202X,routine CT showed a complete response. No further CT findings were observed until April,2 years after 202X,when a polycystic lesion in the left kidney was observed. In August, 3 years after 202X, she complained of high fever and presented to our hospital. Her blood test showed a high c-reactive protein (CRP) levels; therefore, she was admitted and received levofloxacin drip infusion for 5 days. However, the CRP level was elevated, and she underwent CT,which revealed a significant increase in the size and number of left polycystic lesions. She was diagnosed with multiple left renal abscesses and underwent a percutaneous left renal abscess puncture. Despite continued percutaneous drainage and antibiotic infusion, the high fever and elevated CRP level persisted. Therefore, she underwent left open nephrectomy. Pathology of the left kidney revealed a renal abscess,but there was no sign of malignancy. Crizotinib has been reported to cause rare adverse effects, such as polycystic renal lesions or renal abscesses.