Melanoma is known to express high levels of GLUT-1,12 and in vitro studies show high levels of glycolysis and lactate production.13–15 The elevated urinary metabolites prior to therapy, the lack of symptoms with high lactate and low glucose (the patient only became symptomatic when acidotic) and the low glucose uptake in the brain on PET scan all suggest that this was a chronic state. Here, SLC2A1 is linked to melanoma.