转移性透明细胞肾细胞癌患者中仑伐替尼相关可逆性后部脑病综合征：一例病例报告
Lenvatinib-Associated Posterior Reversible Encephalopathy Syndrome in a Patient With Metastatic Clear Cell Renal Cell Carcinoma: A Case Report.
摘要(中文译文)
后部可逆性脑病综合征（PRES）是一种罕见但严重的神经系统并发症，与包括仑伐替尼在内的血管内皮生长因子受体（VEGFR）酪氨酸激酶抑制剂相关。我们报告一例63岁女性转移性透明细胞肾细胞癌患者在接受帕博利珠单抗联合仑伐替尼治疗孤立性胰腺转移期间发生PRES的病例。在开始仑伐替尼治疗两天后，患者出现头痛、意识模糊、视幻觉，并在严重高血压背景下发生全面性强直-阵挛发作。脑磁共振成像显示双侧顶枕叶血管源性水肿，符合PRES表现。停用仑伐替尼，并给予降压及抗癫痫治疗，患者临床症状在两周内完全恢复，随访影像学显示病灶消退。帕博利珠单抗维持单药治疗，未再出现PRES复发。本病例强调了在开始VEGFR酪氨酸激酶抑制剂治疗后短期内出现神经系统症状的患者中，及时识别、停药、血压控制及支持治疗的重要性。
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a rare but serious neurologic complication associated with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors, including lenvatinib. We report a case of PRES in a 63-year-old woman with metastatic clear cell renal cell carcinoma treated with pembrolizumab and lenvatinib for isolated pancreatic metastases. Two days after lenvatinib initiation, she developed headaches, confusion, visual hallucinations, and a generalized tonic-clonic seizure in the setting of severe hypertension. Brain magnetic resonance imaging demonstrated bilateral parieto-occipital vasogenic edema consistent with PRES. Lenvatinib was discontinued, and she was treated with antihypertensive and antiepileptic therapy, with complete clinical recovery within two weeks with radiographic resolution on follow-up imaging. Pembrolizumab was maintained as monotherapy without PRES recurrence. This case highlights the importance of prompt recognition, drug discontinuation, blood pressure control, and supportive management in patients who develop neurologic symptoms shortly after starting VEGFR tyrosine kinase inhibitors.
如何引用
AMA
Nasong A Luginaah, Seth Climans, Aquila Akingbade. Lenvatinib-Associated Posterior Reversible Encephalopathy Syndrome in a Patient With Metastatic Clear Cell Renal Cell Carcinoma: A Case Report.. Cureus. 2026; doi:10.7759/cureus.111672.
APA
Nasong A Luginaah, Seth Climans, Aquila Akingbade (2026). Lenvatinib-Associated Posterior Reversible Encephalopathy Syndrome in a Patient With Metastatic Clear Cell Renal Cell Carcinoma: A Case Report.. Cureus. https://doi.org/10.7759/cureus.111672
GB/T 7714
Nasong A Luginaah, Seth Climans, Aquila Akingbade. Lenvatinib-Associated Posterior Reversible Encephalopathy Syndrome in a Patient With Metastatic Clear Cell Renal Cell Carcinoma: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.111672.
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