ArticleJournal of neurosurgery. Case lessons2025
Intratumoral hemorrhage from brain metastases following nivolumab therapy for malignant melanoma: illustrative case.
Article in Journal of neurosurgery. Case lessons, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
- Continuing immune checkpoint inhibitors after pseudoprogression improves survival in lung cancer patients: a systematic review and meta-analysis.Journal of thoracic disease · 2025Article
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6 authors.
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Abstract
backgroundMalignant melanoma is a highly aggressive type of cancer that frequently causes brain metastases, leading to poor outcomes. Immune checkpoint inhibitors (ICIs), such as nivolumab, play a crucial role in treating metastatic melanoma, yet intracranial hemorrhage (ICH) is a rare but serious complication. Although pseudoprogression and hyperprogressive disease are recognized phenomena associated with ICIs, the precise mechanisms connecting ICIs to ICH are not yet fully understood. OBSERVATIONS: The authors report the case of a 75-year-old man with stage IV malignant melanoma who experienced an ICH 5 days after starting nivolumab monotherapy. Imaging revealed a hemorrhagic brain metastasis in the left temporal lobe, necessitating a craniotomy. Histopathology confirmed melanoma metastasis without signs of pseudoprogression or hyperprogressive disease. The patient received whole-brain radiation therapy after surgery but continued to exhibit persistent aphasia and cognitive decline deficits. LESSONS: Early-phase intratumoral hemorrhage can occur shortly after ICI therapy, presenting diagnostic and management challenges. While this complication may result from the tumor's inherent hemorrhagic potential or ICI-induced changes such as pseudoprogression, hyperprogressive disease, or tumor lysis, its precise cause often remains unclear. Close monitoring during ICI treatment is essential to promptly address these potentially life-threatening events. https://thejns.org/doi/10.3171/CASE2581.
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