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In 2020, a 45-year-old woman underwent a right nephrectomy for a localised clear-cell renal cell carcinoma. A year later, she experienced a febrile metastatic relapse with a large 15 cm thoracic para-aortic mass and a pleural effusion. An exhaustive investigation concluded to a febrile state linked to tumour progression. The patient was treated with a combination of nivolumab (anti PD-1; 3 mg/kg every 3 weeks) and ipilimumab (anti CTLA-4; 1 mg/kg every 3 weeks) associated with oral prednisone at 20 mg/day to treat the fever. After 3 months of treatment, she experienced a good clinical response, and the fever disappeared. Partial response was observed on CT imaging, after which prednisone was discontinued.
One month later, the fever reappeared, associated with …
Handling editor Josef S Smolen
Contributors Planning: EA, GF and GB. Conducting: EA, AAPG, DH, GP, GF and GB. Reporting: EA, GF and GB.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.