Purpose: Immunotherapy, recently approved for melanoma treatment, is associated with unique immunological adverse events. Pancreatitis is a known clinical adverse event, however, less documented radiologically. The purpose of the study was to assess the imaging findings of the pancreas in patients receiving immunotherapy and correlate them with clinical abnormalities.
Material & Methods: CT scans of consecutive melanoma patients, pre- and post- immunotherapy initiation in the years 2013-2016, were retrospectively evaluated for pancreatic changes. In the patients with pathological findings, clinical data was retrieved. IRB approval was obtained.
Results: 14/158 patients exhibited pancreatic radiologic changes, including pancreatic atrophy and peri-pancreatic fat stranding. A salient finding in 12 of these patients was a rogressive diffuse atrophy of the pancreas, which, in two patients, was associated with prolonged diarrhea and steatorrhea, resolved with pancreatic enzyme replacement therapy, and was consistent with exocrine failure.
Conclusion: Pancreatic changes, particularly atrophy, previously not described on CT, are under-recognized adverse events of immunotherapy.
