Nivolumab-Induced Hypophysitis Leading To Hypopituitarism And Secondary Empty Sella Syndrome In A Patient With Non-Small Cell Lung Cancer

We describe the clinical course of a 64-year-old woman with stage IVa lung adenocarcinoma who presented with over 1month of fatigue, unintentional weight loss and emesis. She initiated treatment with nivolumab immunotherapy 1year prior and had been tolerating the treatment well. A comprehensive workup revealed multiple endocrinological abnormalities consistent with hypophysitis leading to hypopituitarism in the form of central adrenal insufficiency and hypogonadism as well as a partially empty sella on imaging. This case demonstrates that while receiving novel forms of treatment such as immunotherapy, patients should be monitored closely for a wide range of adverse effects.