Is it metastatic melanoma or is it sarcoidosis? Non-caseating granulomas due to pembrolizumab

Abstract

This patient received adjuvant intensity-modulated radiotherapy, followed by intravenous pembrolizumab 200 mg every 21 days with a planned total duration of 1 year. He tolerated six cycles of pembrolizumab with only mild fatigue and cough. Follow-up PET/CT scan after these cycles revealed possible progression of his disease. There was fluorodeoxyglucose-avid adenopathy throughout the mediastinum, bilateral infraclavicular and supraclavicular nodes, and likely periaortic and porta hepatis nodes (figure 1).