Hypophysitis induced by anti-programmed cell death protein 1 immunotherapy in non-small cell lung cancer: Three case reports

Figure 1 Pituitary magnetic resonance imaging and laboratory examination results in case 1. A: The pituitary was normal before starting immunotherapy (November 30, 2019); B: Pituitary enlargement was not found at the onset of immune-related hypophysitis (July 26, 2020); C: The pituitary was normal after steroid treatment (December 18, 2020); D: The levels of adrenocorticotropic hormone and cortisol; E: The levels of thyroid stimulating hormone and free thyroxine. ACTH: Adrenocorticotropic hormone; TSH: Thyroid stimulating hormone; FT4: Free thyroxine.

Figure 2 Pituitary magnetic resonance imaging and laboratory examination results in case 2. A: The pituitary was normal when the patient developed nausea and vomiting for the first time; B: Pituitary enlargement was not found when the patient complained of nausea and vomiting for the second time; C: The pituitary was normal after 2 mo of steroid treatment; D: Adrenocorticotropic hormone and cortisol levels; E: Thyroid stimulating hormone and free thyroxine. ACTH: Adrenocorticotropic hormone; TSH: Thyroid stimulating hormone; FT4: Free thyroxine.

Figure 3 Imaging examination and laboratory results in case 3. A: Chest computed tomography (CT) image at baseline; B: Chest CT image after two cycles of combination therapy; C: The pituitary was normal before combination therapy (June 9, 2020); D: Pituitary enlargement was found after two cycles of combination therapy (August 8, 2020); E: The pituitary was normal after nearly 2 mo of steroid treatment (September 27, 2020); F: Adrenocorticotropic hormone and cortisol levels; G: Thyroid stimulating hormone and free thyroxine. ACTH: Adrenocorticotropic hormone; TSH: Thyroid stimulating hormone; FT4: Free thyroxine.