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肾细胞癌患者舒尼替尼治疗后复发性下颌下瘘：一例报告

Recurrent submandibular fistula after Sunitinib treatment in a patient with renal cell carcinoma: a case report.

作者信息

Golu Mihai Vlad, Paşcanu Ionela, Petrovan Cecilia, Cosarca Adina, Bereczki Despina Temistocle, Ormenisan Alina

机构信息

George Emil Palade University of Medicine, Pharmacy, Science, and Tehnology of Targu Mures, Targu Mures, Romania.

IOSUD of UMPhST G.E. Palade Tg. Mureș, Romania.

出版信息

Med Pharm Rep. 2023 Jul;96(3):323-327. doi: 10.15386/mpr-2502. Epub 2023 Jul 27.

DOI:10.15386/mpr-2502
PMID:37577019
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10419685/
Abstract

Sunitinib is commonly used in the treatment of patients with renal cell carcinoma and is associated with serious side-effects. We present the first report of a recurrent submandibular fistula in a patient treated with sunitinib. A 68-year-old man was referred to our clinic for a cutaneous fistula situated on the right side of his lower jaw. The patient had been diagnosed with bone metastases from a renal carcinoma 2 years ago and had received a single 4 mg dose of zoledronic acid and subsequent treatment with sunitinib 37.5 mg once daily for the past 4 weeks. The patient was treated surgically by a perilesional incision and primary closure with sutures, advised on meticulous oral hygiene and was kept on an antimicrobial agent in the form of clindamycin. After reinitiating his oncological treatment with sunitinib the cutaneous fistula re-appeared and bone abnormalities were also detected on his X-ray. After 18 months a contralateral cutaneous fistula was observed along with a spontaneous avulsion of the patient's left molar. Repeat surgical treatment and sequestrectomy was performed with the subsequent histopathological examination revealing a suspicion of osteonecrosis of the jaw and an associated Actinomyces infection.

摘要

舒尼替尼常用于治疗肾细胞癌患者，且会引发严重的副作用。我们报告了首例接受舒尼替尼治疗的患者出现复发性下颌下瘘的情况。一名68岁男性因下颌右侧皮肤瘘被转诊至我院。该患者两年前被诊断为肾癌骨转移，曾接受单次4毫克剂量的唑来膦酸治疗，随后在过去4周内每天服用37.5毫克舒尼替尼。患者接受了病灶周围切口手术及一期缝合，接受了细致口腔卫生指导，并持续使用克林霉素形式的抗菌药物。在用舒尼替尼重新开始肿瘤治疗后，皮肤瘘再次出现，X线检查还发现了骨质异常。18个月后，观察到对侧皮肤瘘，同时患者左侧磨牙自发脱落。再次进行了手术治疗和死骨切除术，随后的组织病理学检查显示怀疑有颌骨骨坏死及相关放线菌感染。

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