Fig. 4

Paradoxical acceleration of tumour growth kinetics in a patient with metastatic melanoma treated with ipilimumab and nivolumab. Baseline axial CT image and corresponding ¹⁸F-FDG PET/CT image show few perisplenic peritoneal metastatic implants. Two months after the initiation of immunotherapy, both imaging modalities show a dramatic increase in peritoneal metastases.