Immune-Related Omentitis Induced by Ipilimumab and Nivolumab in Advanced Melanoma: A Case Report

Sidsel Pedersen, Karina Seierøe, Gina Al-Farra, Eva Ellebaek, Marco Donia, Inge Marie Svane and Troels Holz Borch

National Center for Cancer Immune Therapy, Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark Department of Radiology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Denmark

^*Correspondance to: Troels Holz Borch 

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Abstract:

Introduction: Immune Checkpoint Inhibitors (ICIs) have revolutionized cancer therapy, particularly for advanced melanoma. However, their potent immune activation can result in immune-related adverse events (irAEs), affecting various organ systems. Case Presentation: We report a case of a 54-year-old male with metastatic melanoma treated with combined ipilimumab and nivolumab, who developed immune-related omentitis - a rare irAE not previously described in literature. After three cycles of immunotherapy, the patient presented with nonspecific symptoms, including malaise, weight loss, and elevated C-reactive protein and alkaline phosphatase levels. Initial treatment with antibiotics on suspicion of infection was ineffective, and abdominal imaging revealed inflammation of the omentum majus. The patient responded well to corticosteroid therapy, leading to complete resolution of symptoms and normalization of biochemical markers. Subsequent imaging showed resolution of omental inflammation. Discussion: This case highlights the importance of recognizing atypical irAEs in patients undergoing ICI therapy. Immune-related omentitis might represent an underdiagnosed irAEs needing management. Increased awareness and reporting of rare irAEs are essential for optimizing patient management. Further research is needed to better understand the underlying mechanisms and establish treatment guidelines for such uncommon presentations.

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Cite the Article:

Pedersen S, Seierøe K, Al-Farra G, Ellebaek E, Donia M, Svane IM, et al. Immune-Related Omentitis Induced by Ipilimumab and Nivolumab in Advanced Melanoma: A Case Report. Ann Clin Case Rep. 2024; 9: 2701..