Sintilimab‑related cystitis/ureteritis in high‑grade endometrial stromal sarcoma: A case report and structured literature review.
Shuhan Yang, Ruike Gao, Daorui Li et al.
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Case in brief
A 44-year-old woman with high-grade endometrial stromal sarcoma developed severe urinary symptoms after three cycles of sintilimab combined with nab-paclitaxel and carboplatin. Initial antibiotic treatment was ineffective, but imaging showed bladder and ureteral wall thickening. Treatment with methylprednisolone led to significant symptom improvement, and a urine culture revealed Enterococcus faecalis. After adding piperacillin-tazobactam, her symptoms resolved, and she tolerated a rechallenge with sintilimab with only mild urinary symptoms.
What made this case unusual
This case highlights sintilimab-related cystitis/ureteritis, a rare immune-related adverse event, particularly in the context of high-grade endometrial stromal sarcoma treatment.
Diagnostic / clinical pearl
Clinicians should consider immune-related cystitis/ureteritis in patients receiving immune checkpoint inhibitors who present with urinary symptoms, especially when standard treatments fail.
Why it matters
Understanding the potential for immune-related adverse events like cystitis/ureteritis is crucial for managing patients on immune checkpoint inhibitors and ensuring timely and appropriate interventions.