Open Access

RESIDENT’S CORNER

Ileal perforation in the setting of atezolizumab immunotherapy for advanced bladder cancer

Jacqueline Zillioux¹, Matthew DiLizia², Basil Schaheen³, Rudolph Rustin³, Tracey L. Krupski¹

1 Department of Urology, University of Virginia, Charlottesville, Virginia, USA
2 University of Arizona College of Medicine, Phoenix, Arizona, USA
3 Department of Surgery, University of Virginia, Charlottesville, Virginia, USA
Address correspondence to Dr. Jacqueline Zillioux, Department of Urology, University of Virginia, PO Box 800422, Charlottesville, VA 22908 USA

Canadian Journal of Urology 2018, 25(5), 9525-9526.

Abstract

Atezolizumab is a promising immunotherapy for advanced urothelial carcinoma. Like other immune checkpoint inhibitors, it can produce rare immune-related adverse events (IRAEs). Here we present the recent case of a patient with metastatic bladder cancer who developed diarrhea and abdominal pain months after beginning atezolizumab therapy. He presented to our institution with an ileal perforation secondary to atezolizumabinduced enterocolitis. After surgical repair, the patient’s condition improved, and he was discharged. We discuss the management of atezolizumab-induced enterocolitis, including the importance of early recognition and intervention to prevent more devastating complications.

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