Immunotherapy induced sarcoidosis in a 47-year-old female with stage IIIC cervical cancer on pembrolizumab: A case report

• Immunotherapy induced sarcoidosis secondary to pembrolizumab. • Toxicities of immune checkpoint inhibitors in gynecologic malignancies. • Tissue biopsy − the gold standard for differentiating sarcoidosis from metastasis. • Discontinuing immunotherapy and starting corticosteroids for sarcoid-like reactions. As immune-checkpoint inhibitors (ICIs) use increases in gynecologic oncology, it is imperative to remain alert for immune-related adverse events (irAEs). Although ICI-induced sarcoidosis is a rare irAE, it can closely mimic metastatic progression on radiographic imaging and requires prompt recognition and treatment to minimize interruptions to immunotherapy treatment. A 47-year-old with stage IIIC cervical cancer on maintenance pembrolizumab experienced multiple immune-related adverse events which interfered with consistent treatment. Immunotherapy induced sarcoidosis was eventually diagnosed with tissue biopsy after multiple imaging studies failed to differentiate between osseous metastases versus inflammation. She is undergoing current treatment with steroid and methotrexate treatment and temporary discontinuation of immunotherapy. This is the first reported cases of ICI-induced sarcoidosis in a patient with cervical cancer. Given the radiographic similarities between metastases and sarcoidosis, continued surveillance throughout ICI therapy is essentially, especially given that the incidence of irAEs will likely rise with increased ICI use in gynecologic oncology. This case also demonstrates the importance of multidisciplinary collaboration in managing ICI-related toxicities.