Rare osteoarticular complications on [18F]FDG-PET/CT - following intravesical BCG immunotherapy for bladder cancer.

Rare Side Effects of BCG Immunotherapy: A Case Study

Bacillus Calmette-Guérin (BCG) immunotherapy, a common treatment for bladder cancer, has proven effective in preventing tumor recurrence. However, like a desert traveler encountering unexpected storms, patients can experience rare and sometimes unexpected side effects from BCG immunotherapy. This case study illustrates a rare osteoarticular complication of BCG immunotherapy in a 55-year-old male with high-risk non-muscle-invasive bladder cancer.

A Rare But Real Side Effect: Reactive Arthritis

The patient presented with nearly symmetrical uptakes in the costovertebral and costotransverse joints on an 18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) scan, suggestive of reactive arthritis (ReA). ReA, a rare autoimmune complication of BCG, was successfully treated with a nonsteroidal anti-inflammatory drug (NSAID). This case highlights the importance of recognizing and managing potential side effects associated with BCG immunotherapy.

Navigating the Unexpected

This case study serves as a reminder that even with proven treatments, unexpected side effects can occur. It underscores the importance of careful monitoring, prompt recognition, and appropriate management of potential complications. Like a desert nomad preparing for unexpected challenges, healthcare professionals must be vigilant in identifying and addressing potential side effects, ensuring the safety and well-being of their patients.

Dr. Camel's Conclusion

This case study highlights the importance of being aware of rare but potentially serious complications associated with BCG immunotherapy. It emphasizes the need for vigilant monitoring and prompt management of these complications, reminding us that even the most effective treatments can have unexpected consequences.