PMC9807438_01
(a) Chest X-ray, (b) contrast-enhanced computed tomography (CT), (c) contrast-enhanced head magnetic resonance imaging (MRI), and (d) positron emission tomography/computed tomography (PET/CT) at first admission. An irregular tumor was present in the right lower lobe, a metastatic brain tumor was detected in the left parietal lobe, and fluorodeoxyglucose uptake was noted. The maximum standardized uptake value (SUVmax) was 19.2
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Chest X-ray (Figure 1a) and contrast-enhanced computed tomography (CT) showed the tumor in the right lower lobe (Figure 1b) and mediastinal lymph node swelling. Contrast-enhanced head magnetic resonance imaging revealed a metastatic brain tumor (Figure 1c). Positron emission tomography/CT showed the uptake of fluorodeoxyglucose (FDG) in the tumor and mediastinal lymph nodes, with a maximum standardized uptake value of 19.2 (Figure 1c).
Clinical course of the present case. The patient was diagnosed with type 1 diabetes 7 months after the discontinuation of pembrolizumab. Following the initiation of insulin therapy, the normalization of HbA1c was achieved
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HbA1c was 4.9% 3 months after the completion of pembrolizumab, and dry mouth and polyuria occurred after 5 months (Figure 2). The patient is being monitored for lung cancer and antitumor effects are continuing (Figure 2).