Purpose. To demonstrate the course of drug induced pneumonitis after treatment with nivolumab in a patient with kidney cancer and distant metastasis. To show the development and course of nivolumab induced pneumonitis and differential diagnosis using computed tomography.

Materials and methods. A clinical case of a patient with cancer of a single kidney and a distant metastasis is presented. The analysis of follow up chests CTs was made.

Results. The presented clinical case demonstrates both: new treatment options for metastatic kidney cancer and the complications associated with this treatment. A retrospective analysis allowed us to assess the speed of the reverse development of symptoms on the background of hormonal therapy, as a result, the presence of drug induced pneumonitis. Computed tomography revealed a predominance of unilateral lesion; patterns corresponding to organizing pneumonia were identified.

Conclusion. This clinical case emphasizes the importance of computed tomography, which allows differential diagnosis of tumor progression, inflammation, and drug induced pneumonitis. Knowledge of advanced approaches to cancer treatment and awareness of emerging complications from new treatments being introduced is essential for clinicians and radiologists.