Case Report
Copyright ©The Author(s) 2020.
World J Gastroenterol. Apr 28, 2020; 26(16): 1971-1978
Published online Apr 28, 2020. doi: 10.3748/wjg.v26.i16.1971
Table 1 Timeline
June 2018Removal of mole on the right thigh at the general practitionerPathology showed malignant melanoma, 2.1 mm. Level IV
AugustRe-excision of malignant melanoma and sentinel node biopsyStage IIIb malignant melanoma. (No open protocol for adjuvant treatment)
SeptemberPET-CTNo metastases
DecemberMultidisciplinary team-conferenceReferred to the oncology department
January 2019Started adjuvant Nivolumab treatment
MarchNausea and stomach painGrade 1 hepatitis (ALT 129 U/L)
AprilUltrasound of liver because of elevated ALTNormal
MayDecline in ALT (ALT 47 U/L), 6th dose of Nivolumab
June 21-24First admission for 3 d with nausea, stomach pain, and vomiting; Cerebral MRIShort prednisone treatment with initial effect. No brain metastasis
July 1PET-CT (Figure 1)FDG-uptake in the gastric wall
July 3Second admission with vomiting, stomach pain, and nauseaALT 85 U/L, albumin 23 g/L
July 4EGD and EUS (Figure 2); Initiated methylprednisolone 80 mg iv.Gastritis. Erythematous mucosa with severe, fibrinous erosions. Acute and chronic inflammation
July 10First dose Infliximab
July 11Discharged; continued prednisone
July 18Initiated tapering of prednisone
July 24Second dose Infliximab
August 8EGDSlight to moderate gastritis without ulcerations and fibrinous membranes. Improvement compared to the first EGD
September 17PET-CT (Figure 4)No FDG uptake in the gastric wall
September 26Discontinued prednisone