Background: In 2020, melanoma exhibited the 5th highest incidence rate of all cancers in the US. While metastatic melanoma constitutes only 4% of new melanoma cases, the 5-year survival rate of metastatic melanoma is 27% [1]. Immune Checkpoint Inhibitors (ICIs) were the first drugs to significantly improve the 5-year survival of late-stage melanoma patients; these [...]

Case Presentation: A 66-year-old female with a history of stage IV non-small cell lung cancer (NSCLC) (90% PD-L1 +) on pembrolizumab (status post cycle 9) with metastasis to the left adrenal gland presented with a two-week history of malaise, nausea, and vomiting. Vital signs were stable and physical exam was euvolemic, with mild epigastric tenderness. [...]

Case Presentation: A 66-year-old man with a history of stage IIId melanoma, who received 6 cycles of Nivolumab, presented with anorexia and persistent large-volume diarrhea. Initial workup included a non-elevated white blood cell count of 6.9 k/mm3 and a creatinine of 1.6 mg/dL from baseline creatinine of 0.8 mg/dL. CT imaging of the abdomen showed [...]

Case Presentation: A 70 year old male with metastatic malignant melanoma on immunotherapy with nivolumab and ipilimumab was sent to the hospital by his oncologist for abdominal pain and elevated liver enzymes.  His labs were notable for AST 275, ALT 1138, alkaline phosphatase of 394 and total bilirubin of 3.94. This patient had no known [...]

Case Presentation: A 67 year old Caucasian male with history of squamous cell carcinoma of the lower lobe of the left lung was admitted to the hospital after his pre-chemotherapy laboratory work at his oncologist showed elevated liver enzymes (AST 162, ALT 141), elevated CK (2856), CK-MB (104) and elevated troponin (0.83). The patient had [...]

Case Presentation: A 74-year-old man with a medical history of hepatitis C cirrhosis post-treatment was evaluated after he was found to have hepatocellular carcinoma on abdominal MRI. The carcinoma occupied almost the entire right hepatic lobe with macrovascular invasion without evidence of metastatic disease. The initial alpha-fetoprotein level exceeded 2000 nanograms per milliliter. Subsequently, the [...]

Case Presentation: An 86-year-old male with a past medical history of bladder cancer, status post Bacillus Calmette-Guerin (BCG) therapy 12 months prior, presented to the ED with three months of progressively worsening back pain and weight loss. He denied cough, fever, night sweats, dysuria, recent travel, history of farming, exposure to cattle, or consumption of [...]

Case Presentation: Our patient was a 58 year old male with a history of metastatic melanoma on nivolumab and ipilimumab who was directly admitted from clinic to the medicine service for increased lethargy and flu-like symptoms. The patient described a one week history of fevers/chills, headache, muscle ache, and malaise; as well as nausea, vomiting, [...]

Case Presentation: A 79-year-old male patient with a history significant for metastatic melanoma to the right axillary lymph node and recurrent diarrhea secondary to ipilimumab-induced colitis is admitted for uncontrolled diarrhea with rectal bleeding.  He has had several prior admissions for diarrhea, which have been successfully treated with IV steroids, but has recurrent diarrhea when [...]

Case Presentation: A 66-year-old female with metastatic small cell lung cancer involving brain, liver, and bones was admitted via ED with generalized weakness, mild confusion, and decreased oral intake for 3 days. She was initiated on immunotherapy with immune checkpoint inhibitors, ipilimumab (human cytotoxic T-lymphocyte antigen 4 (CTLA-4)-blocking antibody) and nivolumab (a programmed death receptor-1 [...]