BMJ Case Reports 2018; doi:10.1136/bcr-2018-224913
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Severe inflammatory ileitis resulting in ileal perforation in association with combination immune checkpoint blockade for metastatic malignant melanoma

Editor's Choice
  1. Guy Faust5
  1. 1 Department of Oncology, University Hospitals of Leicester NHS Trust, Leicester, UK
  2. 2 Leicester Cancer Research Centre, University of Leicester, Leicester, UK
  3. 3 Department of Pathology, University Hospitals of Leicester NHS Trust, Leicester, UK
  4. 4 Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK
  5. 5 Department of Oncology, University Hospitals of Leicester, Leicester, UK
  1. Correspondence to Dr Ali Abdulnabi Mohamed, ali-abdulnabi.mohamed{at}
  • Accepted 21 March 2018
  • Published 5 April 2018


Immune checkpoint inhibitors have become standard of care in metastatic malignant melanoma management. Despite superior effectiveness to chemotherapy, significant immune-related adverse events (irAE) may occur, particularly if used in combination. Gastrointestinal irAEs were reported with different patterns of involvement. Here, we report the case of a patient who had ileal perforation as a complication of terminal ileitis, without colitis, induced by combination immune checkpoint blockade.


  • Contributors AAM conceived the case report, reviewed the literature and prepared the first manuscript draft. CJR contributed with the histopathological notes and images and reviewed the manuscript. KB contributed with the surgical notes and reviewed the manuscript. GF contributed to the conception of the case report and reviewed the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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