Mediastinal and hilar sarcoid-like reaction in a patient treated with dabrafenib and trametinib for metastatic melanoma: A case report and review of the literature.

BRAF/MEK inhibitors are considered standard of care in the treatment of advanced BRAF-mutated malignant melanoma, and have been, in rare cases, associated with granulomatous reactions, mostly limited to skin lesions. The present study reported the case of a patient with metastatic melanoma developing a sarcoid-like reaction manifesting as asymptomatic mediastinal and right hilar lymphadenopathy while on antineoplastic therapy with dabrafenib and trametinib. To the best of our knowledge, this is the first reported case of isolated lymphadenopathy as a manifestation of drug-induced sarcoid-like reaction under dabrafenib and trametinib. Overall, only 17 other cases of granulomatosis have been reported in the literature. Although uncommon, such reactions should be considered in the differential diagnosis of lymph node enlargement, and distinguishing them from tumor progress is important and can be challenging in clinical practice.