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Case Report: Immune checkpoint inhibitor-induced myositis/myocarditis with myasthenia gravis-like symptoms in a colon cancer patient with suspected thymic metastasis
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DOI：10.3389/fonc.2026.1808170.png)
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Abstract
En 中文
BackgroundThe Widespread application of immune checkpoint inhibitors (ICIs) has led to a noticeable increase in patients developing the triad of severe myasthenia gravis (MG); myocarditis; and myositis. However; this overlapping triad syndrome is still very rare; characterized by a subtle onset; a rapid progression; and a high mortality rate. Due to its insidious onset and diagnostic challenges; there is currently limited knowledge of this overlapping triad syndrome in clinical settings.Case presentationWe report the case of a male colon cancer patient with suspected thymic metastasis who developed the overlapping immune-related myocarditis; myositis; and MG-like symptoms after one cycle of ICI treatment. The patient received timely administration of corticosteroids; oxygen therapy; immunoglobulin; and other treatments; following which he recovered and was discharged. No discernible adverse impact on his subsequent quality of life was observed.ConclusionsVigilance is warranted for the risk of developing a triad of severe MG; myocarditis; and myositis when patients receiving ICIs present with symptoms such as exertional dyspnea; swallowing weakness; diplopia; dysarthria; limb weakness; or inability to walk due to muscle pain; particularly for patients with thymic masses. Such patients should be monitored in the hospital and; if necessary; admitted to the intensive care unit; where they will be managed by a multidisciplinary team of specialists.
Keywords:
immune checkpoint inhibitors
colon cancer
myocarditis
myositis
myasthenia gravis
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