{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:43:54Z","timestamp":1777934634252,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pembrolizumab is a humanized monoclonal antibody IgG4 programmed cell death protein 1 antagonist, and its use in oncology has been increasing in recent years, providing durable and favorable responses and tolerable toxicity profiles in various types of cancer. We describe a case of pembrolizumab related perforated appendicitis in a patient with stage 3C malignant melanoma (MM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 70-year-old male patient who had no known disease was diagnosed with MM as a result of the excision of the mass on his right shoulder. The disease stage was stage 3C (pT4aN1bM0). Subsequently, adjuvant pembrolizumab treatment was started. A few days after the fourth maintenance course, he presented to the emergency department complaining of abdominal pain, nausea and vomiting. Emergency abdominal tomography showed a significant increase in the diameter of the appendix vermiformis, peritoneal thickening and appendiceal wall defects that could be significant in terms of perforation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management and outcome<\/jats:title>\n                    <jats:p>The mentioned finding and given the clinical presentation, was attributed to a perporating of the appendix, so the patient was hospitalized in the Department of Surgery and the patient underwent emergency appendectomy. Histological findings were consistent with appendicitis. After a day in the hospital, the abdominal pain subsided, C-reactive protein tended to decrease and the patient was discharged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In patients who develop acute abdominal pain with or without diarrhea during immunotherapy, urgent imaging, endoscopic and clinical evaluation should be performed, and bowel perforation, although rare, should be considered as a potential complication of any immunotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552241271026","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T19:24:53Z","timestamp":1722626693000},"page":"1455-1459","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Pembrolizumab related perforated appendicitis"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3041-0134","authenticated-orcid":false,"given":"Murat","family":"Kirac\u0131","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3426-9505","authenticated-orcid":false,"given":"Selin","family":"Akturk Esen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duriye Ozer","family":"Turkay","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahriye Tugba","family":"Kos","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"bibr1-10781552241271026","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503093"},{"key":"bibr2-10781552241271026","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz011"},{"key":"bibr3-10781552241271026","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2020-001806","volume":"8","author":"Ferrucci PF","year":"2020","journal-title":"J Immunother Cancer"},{"key":"bibr4-10781552241271026","volume":"360","author":"Baxi S","year":"2018","journal-title":"Br Med J"},{"key":"bibr5-10781552241271026","doi-asserted-by":"publisher","DOI":"10.1111\/his.13118"},{"key":"bibr6-10781552241271026","first-page":"3406437","volume":"2018","author":"Celli R","year":"2018","journal-title":"Case Rep Gastrointest 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