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A 22-year-old woman presented in December 2017 with a 2-month history of postprandial abdominal pain, nausea, vomiting, early satiety and 4 kg weight loss. She had entirely normal bowel habit. She did not use non-steroidal anti-inflammatory drugs and omeprazole had not helped her symptoms. Her medical history included resection of 1.8 mm Spitz melanoma in June 2010 and left axillary dissection in November 2012 (3/22 nodes positive). She received first-line ipilimumab and nivolumab starting November 2016. Cycle 2 was complicated by grade 2 hepatotoxicity that resolved spontaneously; cycle 4 by grade 3 hepatotoxicity requiring steroids and mycophenolate mofetil (discontinued in August 2017). She had stereotactic radiosurgery for a right temporal lobe metastasis in June 2017 and restarted on maintenance nivolumab monotherapy in July 2017. In December …
Contributors VTFC and OB drafted the manuscript. VTFC and EF prepared the figures. All authors reviewed and edited the final article.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement This is a case report and therefore the data generated are not suitable for sharing beyond that contained within the report. Further information can be obtained from the corresponding author.
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