Hua Yufei, Huang Xuewei, Li Chunjie, Gao Ning
Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
Oral Oncol. 2023 May;140:106369. doi: 10.1016/j.oraloncology.2023.106369. Epub 2023 Mar 28.
Immunotherapy, especially anti-PD-1 and anti-PD-L1 antibodies, have observably improved the overall survival of patients with advanced solid tumors following the unavoidable immune-related adverse events (irAEs). Camrelizumab is a novel anti-PD-1 agent with the reported most common irAEs of reactive cutaneous capillary endothelial proliferation (RCCEP). Despite it is widely occurred in the skin, oral RCCEP is rarely reported.
A 59-year-old man complained about a painless nodule on left mandibular gingiva for two weeks. He started to inject Camrelizumab because of the recurrence of esophageal squamous cell carcinoma two month ago. An 8 mm lesion was observed on his mucosa. Several disseminated bright purple red papules were then found on his skins. The oral lesion and one lesion on his face was removed by surgery. After the final diagnosis of reactive cutaneous capillary endothelial proliferation was confirmed by histological examination. Other operable lesions on his face were removed by ligation. All the removed lesions had a good prognosis without recurrence within the follow-up visit.
With the widespread use of Camrelizumab in other solid tumors, the occurrence of oral RCCEP will increase. Surgery and ligation are both effective treatment for RCCEP with a good prognosis.
免疫疗法，尤其是抗程序性死亡蛋白1（PD-1）和抗程序性死亡配体1（PD-L1）抗体，在不可避免的免疫相关不良事件（irAEs）后，显著提高了晚期实体瘤患者的总生存率。卡瑞利珠单抗是一种新型抗PD-1药物，报告的最常见irAEs是反应性皮肤毛细血管内皮增生（RCCEP）。尽管其在皮肤中广泛发生，但口腔RCCEP鲜有报道。
一名59岁男性因左下颌牙龈无痛性结节两周前来就诊。两个月前他因食管鳞状细胞癌复发开始注射卡瑞利珠单抗。在其黏膜上观察到一个8毫米的病变。随后在其皮肤上发现了几个散在的亮紫红色丘疹。通过手术切除了口腔病变及面部的一个病变。经组织学检查确诊为反应性皮肤毛细血管内皮增生后，对其面部其他可手术切除的病变进行了结扎切除。所有切除的病变预后良好，随访期间无复发。
随着卡瑞利珠单抗在其他实体瘤中的广泛应用，口腔RCCEP的发生率将会增加。手术和结扎都是治疗RCCEP的有效方法，预后良好。
