and cultures were sterile. Work up for autoimmune etiology was negative. He was treated with steroids and diuretics, with good response.

Possibility of late onset autoimmune pericarditis and cardiac tamponade was considered and attributed to the immune related adverse event of ipilimumab which resolved promptly with the use of corticosteroids. Manufacturers of dabrafenib and trametinib were contacted to confirm no previous reports of pericardial effusion with the combination therapy.

Treatment with dabrafenib and trametinib was restarted in November 20, 2015 after cardiac assessment was reported as normal. However, on December 27, 2015 due to reaccumulation of pericardial effusion treatment was interrupted. Pericardial window was required and biopsy reported as nonspecific chronic inflammation. The pericardial fluid analysis revealed a sterile exudate with no evidence of malignancy. Unfortunately during this hospitalization, thereSimms is scheduled to have a salary of $495,000 in 2014, according to league records. The renegotiation may have occurred as early as the regular season. He signed a one-year deal with the team a year ago and made the squad after Greg McElroy suffered a preseason injury and Simms put together a strong training camp.