{
  "abstract": "Merkel cell carcinoma (MCC) is a rare form of skin cancer characterised by a high mortality rate. Despite limited evidence regarding the treatment of metastatic MCC, anti-programmed cell death protein 1 immunotherapy has emerged as a primary strategy for managing advanced stages of the disease. This report presents the case of a woman in her early 80s with stage IV MCC after consultation for declining general health, with the primary lesion remaining unidentified. Pembrolizumab therapy was initiated, which led to acute renal failure after the first infusion. The case highlights the high pathogenicity of MCC and the risk of renal complication associated with pembrolizumab, underscoring the need for vigilance in anticipating and preventing such adverse effects. The discussion examines recent recommendations on the best treatment options for metastatic MCC, which currently includes immunotherapy.",
  "authors": [
    {
      "affiliations": [
        "Service of Internal Medicine, Department of Medicine, Network Hospital Neuchâtel, La Chaux-de-Fonds, Switzerland"
      ],
      "name": "Yohan Depierre"
    },
    {
      "affiliations": [
        "Service of Oncology, Department of Oncology, Network Hospital Neuchâtel, La Chaux-de-Fonds, Switzerland"
      ],
      "name": "Amina Faiza Chouiter-Djebaili"
    },
    {
      "affiliations": [
        "Service of Internal Medicine, Department of Medicine, Network Hospital Neuchâtel, La Chaux-de-Fonds, Switzerland",
        "Service of Intensive Care, Department of Acute Medicine, Geneva University Hospitals, Geneva, GE, Switzerland",
        "Faculty of medicine, University of Geneva, Michel Servet 1, 1211 Geneva 4, Switzerland"
      ],
      "name": "Hervé Zender"
    },
    {
      "affiliations": [
        "Service of Internal Medicine, Department of Medicine, Network Hospital Neuchâtel, La Chaux-de-Fonds, Switzerland"
      ],
      "name": "Chiheb Said"
    }
  ],
  "title": "Fatal outcome after immunotherapy in metastatic Merkel cell carcinoma of unknown primary cause",
  "uid": "f702aacd-2a84-5cab-a323-02c3623c7051"
}