Granulomatous colitis in a patient with metastatic melanoma under immunotherapy: a case report and literature review

Table 1 Summary of studies reporting colon granulomas in patients under ICPIs

Study	ICPIs	Malignancy	Patients with colon biopsies	Median time from drug initiation to GI symptoms onset	Colonoscopy findings	Patients with granuloma(s)	Granuloma features
Miyahara et al. [4]	anti-PD1 (Nivo or Pembro)	LC, PG	7	155 days (nivo)	Rough and friable mucosa, redness and erosions	1	NR
Miyahara et al. [4]	anti-PD1 (Nivo or Pembro)	LC, PG	7	138 days (pembro)	Rough and friable mucosa, redness and erosions	1	NR
Geukes Foppen et al. [5]	Ipi or anti-PD1 or Ipi + anti-PD1 or Ipi + RFA	MM, NSCLC	90	33 days (ipi)	Ulcers, diffuse inflammation, mucosa redness friability	5	Granulomas either in lamina propria or in submucosa
				84 days (anti-PD1)
				27 days (Ipi + anti PD1)
Gonzalez et al. [6]	anti-PD1 (Nivo or Pembro) or anti-PD1 + Ipi	MM, LC, UC, OSCC	17	84 days	Normal mucosa, mild colitis, severe colitis (diffuse or patchy erosions, friability)	3	Granulomasassociated with ruptured crypts
Marthey et al. [7]	Ipi	MM, NSCLC	27	34 days	Erythema, erosions, ulceration	2	Superficial granulomas
Beck et al. [8]	Ipi or Ipi + ΜΜ vaccines	MM, RCC	40	NR	Erythema, ulceration	3	NR

ICPIs immune checkpoint inhibitors, Nivo nivolumab, Pembro pembrolizumab Ipi ipilimumab, RFA radiofrequency ablation, MM metastatic melanoma, LC lung cancer, UC urothelial carcinoma, OSCC oral squamous cell carcinoma, PG pharyngeal cancer, NSCLC non-small cell lung cancer, RCC renal cell carcinoma, NR not reported, GI gastrointestinal

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