Fig. 1

Axial post-contrast FSPGR obtained 1 week after the start of ipi/nivo due to new headaches shows a new 6 mm enhancing (a, arrow) and hemorrhagic left parietal lesion (b, arrow), one of 9 new lesions. 6 week follow-up MRI during ipi/nivo therapy revealed interval hemorrhage of the left parietal lesion (c, arrow) and decreased size of the additional previously enhancing lesions. Axial images from concurrent abdominal CT examinations demonstrate systemic disease response with decreased size and number of hepatic lesions after 6 weeks of ipi/nivo therapy (arrows in e compared to f). After 6 months of therapy, MRI confirmed contraction of the hemorrhagic cavity of the left parietal metastasis (d, arrow) and no new/residual enhancing lesions