Mycophenolic acid/tacrolimus
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Squamous cell carcinoma: case report An approximately 77-year-old man developed squamous cell carcinoma during treatment with mycophenolic acid and tacrolimus for steroid avoidance immunosuppression after kidney transplant. The man, who had a history of autosomal dominant polycystic kidney disease, underwent a kidney transplant with alemtuzumab induction at the age of 70 years followed by mycophenolic acid and tacrolimus [routes and dosages not stated] for steroid avoidance immunosuppression. After 7 years, he reported nonhealing, nonbleeding and pruritic sore over his left temple. Examination revealed he had a 2-cm lesion with heaped-up edges, diffuse actinic lesions over exposed skin and surrounding erythema. Biopsy revealed squamous cell carcinoma. After surgery, he received treatment with external beam radiation. After six months, a PET scan revealed an enhanced activity in the right clavicle, which was treated with radiation therapy and excision. After one year follow-up, a third lesion was observed in the right axilla with the palpable axillary lymph nodes. PET scan was positive, and biopsy of lymph node confirmed metastatic squamous cell carcinoma [duration of treatment to reaction onset not stated]. Nivolumab, an immune checkpoint inhibitor, was recommended for the man’s treatment. However, he died with the cancer after one course of treatment. Ong SC, et al. Use of checkpoint inhibitors in a kidney transplant recipient with metastatic cancer. Clinical Journal of The American Society of Nephrology: CJASN 15: 803502369 1190-1192, No. 8, 7 Aug 2020. Available from: URL: http://doi.org/10.2215/CJN.15941219
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Reactions 26 Sep 2020 No. 1823
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