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She began palliative nivolumab/ipilimumab and initially tolerated therapy without adverse effects, but was hospitalized for Clostridioides difficile colitis after three cycles. Follow-up CT suggested progression; however, PET-CT after discharge demonstrated complete metabolic response across disease sites, supporting pseudo-progression. She continued nivolumab single-agent therapy with good clinical outcome.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/pseudo-progression-of-melanoma-treated-with-nivolumabipilimumab-a-case-report/378102/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/pseudo-progression-of-melanoma-treated-with-nivolumabipilimumab-a-case-report/378102.png","ImageObject",300,407,{"name":92,"@type":93},"Sarah ","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is pseudo-progression in melanoma treatment?","Question",{"text":113,"@type":114},"Pseudo-progression refers to an apparent increase in tumor size caused by tumor inflammation during immunotherapy, which may later resolve rather than reflect true disease growth.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the patient treated and what complication occurred?",{"text":118,"@type":114},"The patient received palliative nivolumab/ipilimumab and tolerated it initially, but was hospitalized for Clostridioides difficile colitis after three treatment cycles.",{"name":120,"@type":111,"acceptedAnswer":121},"Which imaging finding supported pseudo-progression rather than true progression?",{"text":122,"@type":114},"Although CT findings suggested progression, PET-CT showed a complete metabolic response at all disease sites, indicating the initial CT worsening was most likely pseudo-progression.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},378102,1790811358,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":52},962085320529,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","e-ISSN 1941-5923  \n© Am J Case Rep, 2023; 24: e940954 DOI: 10. 12659/AJCR.940954  \nReceived: 2023.04.28  \nAccepted: 2023.06.26  \nAvailable online: 2023.07.06  \nPublished: 2023.08.07  \nAuthors’ Contribution: Study Design A  \nData Collection B Statistical Analysis C Data Interpretation D Manuscript Preparation E Literature Search F Funds Collection G  \nE  \nF  \nBF  \nE  \nCorresponding Author: Financial support: Conflict of interest:  \n1 1  \n1 2  \nPseudo-Progression of Melanoma Treated with Nivolumab/Ipilimumab: A Case Report  \nAdan Martin Cuevas Velazquez Wern Lynn Ng  \nEvelyn J. Calderón Martínez  Sri Lakshmi Hyndavi Yeruva  \n1 Department of Internal Medicine, University of Pittsburgh Medical Center (UPMC) Harrisburg, Harrisburg, PA, USA  \n2 Department of Oncology, University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center, Mechanicsburg, PA, USA  \nAdan Martin Cuevas Velazquez, e-mail: [cuevasvelazquezam@upmc.edu](cuevasvelazquezam@upmc.edu)[ ](cuevasvelazquezam@upmc.edu)None declared  \nNone declared  \nPatient: Female, 74-year-old  \nFinal Diagnosis: Metastatic melanoma • pseudo progression  \nSymptoms: Lump in her chest  \nClinical Procedure: —  \nSpecialty: Oncology  \nObjective: Unusual clinical course  \nBackground: Melanoma is an aggressive skin cancer that can be difficult to manage. Its treatment has been transformed by immunotherapy. Melanoma cells frequently have mutations that make them vulnerable to attack by the immune system, and this is how immunotherapy can fight this cancer. Immunotherapy with checkpoint inhibitors targets mechanisms that malignant cells use to evade immune system detection, blocking proteins produced by the tumor, and allowing the immune system to identify and attack cancerous cells.  \nCase Report: A 74-year-old woman presented with a lump on the right side of her chest. Tests revealed a metastatic malignant tumor with melanocytic differentiation. Stage IV melanoma was diagnosed, and the patient started therapy with nivolumab/ipilimumab for palliative intent, which she tolerated without adverse effects. However, she was hospitalized for Clostridioides difficile colitis after 3 treatment cycles, and computed tomography (CT) scan findings suggested disease progression. Positron emission tomography (PET)-CT obtained after her discharge from the hospital showed a complete metabolic response at all disease sites, indicating the initial progression was most likely a pseudo-progression from the use of immunotherapy. The patient continued with nivolumabas a single agent and has been doing well.  \nConclusions: This case highlights the importance of careful evaluation of immunotherapy response in patients with melanoma. The initial progression noted in this patient was most likely pseudo-progression, which resolved with further immunotherapy. Clinicians should consider PET-CT imaging in cases of suspected pseudo-progression to avoid unnecessary changes in therapy. Patient response to immunotherapy demonstrates the effectiveness of immunotherapy in treating advanced melanoma.  \nKeywords: Immune Checkpoint Inhibitors • Immunotherapy • Ipilimumab • Melanoma • Nivolumab  \nFull-text PDF: [https://www.amjcaserep.com/abstract/index/idArt/940954](https://www.amjcaserep.com/abstract/index/idArt/940954)  \nPublisher’s note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher  \nThis work is licensed under Creative Common AttributionNonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)  \ne940954-1  \nIndexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)][Web of Science by Clarivate]  \n[Cuevas Velazquez A.M. et](Cuevas Velazquez A.M. et) al: Pseudo-progression of melanoma © Am J Case Rep, 2023; 24: e940954","cbCaicMc2BJ3YZLF","https://ap.wps.com/l/cbCaicMc2BJ3YZLF","pdf",678773,"English","# Background\n## Immune checkpoint inhibitors and pseudo-progression\n# Case Report\n## Initial presentation and diagnostic workup\n## Treatment course with nivolumab/ipilimumab\n## Imaging follow-up and pseudo-progression assessment\n# Conclusions","[{\"question\":\"What is pseudo-progression in melanoma treatment?\",\"answer\":\"Pseudo-progression refers to an apparent increase in tumor size caused by tumor inflammation during immunotherapy, which may later resolve rather than reflect true disease growth.\"},{\"question\":\"How was the patient treated and what complication occurred?\",\"answer\":\"The patient received palliative nivolumab/ipilimumab and tolerated it initially, but was hospitalized for Clostridioides difficile colitis after three treatment cycles.\"},{\"question\":\"Which imaging finding supported pseudo-progression rather than true progression?\",\"answer\":\"Although CT findings suggested progression, PET-CT showed a complete metabolic response at all disease sites, indicating the initial CT worsening was most likely pseudo-progression.\"}]","Pseudo-Progression of Melanoma Treated with Nivolumab/Ipilimumab - A Case Report | PDF",1790228510]