For example, 2 recently published case reports with Takotsubo cardiomyopathy presentation differed in final diagnosis and treatment: 1) a patient with melanoma on ipilimumab (anti-CTLA-4) who presented with apical ballooning on TTE and focal 18F-fludeoxyglucose uptake in the cardiac apex on positron emission tomography scan was treated with beta-blockers for Takotsubo cardiomyopathy (8); whereas 2) a patient with hepatocellular carcinoma who presented with mid and apical ballooning after the first dose of nivolumab was treated with high-dose steroids for myocarditis (9). This evidence concerns the gene CTLA4 and hepatocellular carcinoma.