Dar Nakul, Gradecki Sarah E, Gaughan Elizabeth M
University of Virginia School of Medicine, Charlottesville, VA, United States.
Department of Pathology, University of Virginia, Charlottesville, VA, United States.
Front Oncol. 2023 Aug 29;13:1217179. doi: 10.3389/fonc.2023.1217179. eCollection 2023.
Targeted therapies, including BRAF and MEK inhibitors, are valuable treatment options for patients with unresectable or metastatic BRAF V600-mutant melanoma. With the improvement in survival seen with modern melanoma therapeutics, clinicians are learning the variable patterns associated with extended clinical courses. Sarcoidosis is characterized by non-caseating granulomatous inflammation of unknown etiology, often presenting with cutaneous, lung, or lymph node involvement. There is a known association between sarcoidosis and melanoma, and sarcoidosis is increasingly seen and described in the setting of anti-melanoma therapy. The challenge for clinicians is to differentiate between sarcoid-related and malignancy-related findings, which may follow a variable course over years. We present two cases of BRAF and MEK inhibitor-related sarcoidosis in patients with melanoma and review the literature. The dynamic nature of the clinical and radiographic findings impacted patient management and clinical decisions for years of their treatment course.
靶向治疗，包括BRAF和MEK抑制剂，是不可切除或转移性BRAF V600突变型黑色素瘤患者的重要治疗选择。随着现代黑色素瘤治疗方法使患者生存率提高，临床医生正在了解与延长病程相关的多种模式。结节病的特征是病因不明的非干酪样肉芽肿性炎症，常表现为皮肤、肺部或淋巴结受累。结节病与黑色素瘤之间存在已知关联，并且在抗黑色素瘤治疗背景下越来越多地见到并描述结节病。临床医生面临的挑战是区分与结节病相关的发现和与恶性肿瘤相关的发现，这些发现可能在数年中呈现不同病程。我们报告两例黑色素瘤患者中与BRAF和MEK抑制剂相关的结节病病例并复习文献。临床和影像学表现的动态性质影响了患者多年治疗过程中的管理和临床决策。
