Diplopia and skin rash in a patient treated with immunotherapy nivolumab regimen

This is a case report of an 80-year-old caucasian male patient with metastatic urothelial bladder carcinoma and bone/liver metastases, who was being presented with diplopia, raynaud's syndrome and skin rash on both legs, in response to immunotherapy with anti-PDL-1 Nivolumab regimen. Case report An 80-years old patient is being diagnosed with metastatic urothelial bladder carcinoma with liver, bone metastases and para-aortic lymph nodes. The diagnosis was based form liver biopsy. We initiated 1st line chemotherapy with carboplatin plus gemcitabine in March 2019 with a partial response after 3 cycles of therapy in both liver and lymph nodes. In September 2019 was presented with worsening upper abdomen pain and an ultra-sound (US) examination pointed out worsening disease confined to the liver. A new computed tomography (CT) of the abdomen confirmed the results. So, we proceed to a new line of therapy with vinflunine without adverse events. After 6 months in this regimen, a new CT scan showed progressive disease confined to liver and new perihilar lymph nodes in both lungs.