PMC10430778_01
Schematic representation of the patient's treatment history. (A) Treatment timeline. (B) Chest CT images throughout the disease course. (C) Pathological examination of the first lung tissue biopsy. Immunohistochemical testing (100x) results showed positive expression of CK7, Ki67, TTF-1, and PD-L1.
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Here, we report a case of a 67-year-old woman who developed eruptive keratoacanthoma of the skin and T1DM-induced ketoacidosis after treatment with PM8001, a bispecific antibody targeting both PD-L1 and TGF-beta ( Figure 1A ). Computed tomography (CT) on 27 November 2016 showed a left lower lung occupancy ( Figure 1B ). Bronchoscopic biopsy and immunohistochemical (IHC) analysis revealed adenocarcinoma with positive expression of TTF-1, CK7, PD-L1, and Ki67 ( Figure 1C ).
(A) Characterization of facial masses after immunotherapy in patients. (B) The patient experienced regression of the facial mass after discontinuation of the drug.
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However, approximately 6 weeks after the start of treatment (February 2022), multiple facial masses appeared, with the largest one at the right eye angle measuring approximately 2 cm in diameter and protruding from the skin surface ( Figure 2A ). The PM8001 was discontinued because of the severe immune adverse effects, and the facial KA eruptions gradually resolved ( Figure 2B ).
(A) Pathologic biopsy of facial mass ultralow power view. (B) Pathologic biopsy of facial mass magnification 50x. (C) Pathologic biopsy of facial mass magnification 200x.
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The facial mass gradually increased in size over the next 2 weeks, and on 28 February 2022, a definite diagnosis of keratoacanthoma (KA) was made after local excision of the mass ( Figure 3 ).