Third Cranial Nerve Palsy after Monoclonal Antibody Therapy for Lung Cancer: A Case Report

Paolo Missori; Angela Ambrosone; Leonardo Cristofani; Francesco Fattapposta; Antonio Currà

doi:10.1159/000524114

Third Cranial Nerve Palsy after Monoclonal Antibody Therapy for Lung Cancer: A Case Report

Case Rep Ophthalmol. 2022 Apr 21;13(1):282-285. doi: 10.1159/000524114. eCollection 2022 Jan-Apr.

Authors

Paolo Missori¹, Angela Ambrosone¹, Leonardo Cristofani², Francesco Fattapposta³, Antonio Currà⁴

Affiliations

¹ Department of Human Neuroscience, Neurosurgery, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
² Department of Radiological, Oncological and Anatomo-Pathological Sciences, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
³ Department of Human Neuroscience, Neurology Unit A, "Sapienza" University of Rome, Policlinico Umberto I, Rome, Italy.
⁴ Department of Medical-Surgical Sciences and Biotechnologies, Academic Neurology Unit, "Sapienza" University of Rome, Ospedale A. Fiorini, Rome, Italy.

Abstract

Immune checkpoint inhibitors (ICIs) have shown promise in treating cancer patients, and pembrolizumab is a monoclonal IgG4 antibody that targets a human cell surface protein (receptor) called PD-1. Among the side effects, a rare cranial nerve palsy unrelated to the surgical treatment may occur. We report a case of a woman, which after neurosurgical treatment for cerebellar metastasis presented painless third cranial nerve palsy. The benefits of ICIs have been ascertained, but side effects also take place. Neurological symptoms should be recognized early to avoid substantial morbidity, and if necessary, the oncologic treatment should be changed.

Keywords: Cancer; Cranial nerve; Lung; Metastasis; Pembrolizumab; Side effects.

Publication types

Case Reports