Pyogenic granuloma of the gums and lips caused by camrelizumab: case report and literature review

Abstract

Objective To investigate the clinical manifestations, pathological features, and treatment of oral and maxillofacial pyogenic granulomas induced by camrelizumab. Methods A case of pyogenic granuloma of the gums and lips caused by camrelizumab was reported along with a literature review. Results After 4 months of treatment with camrelizumab for liver cancer, the patient developed systemic reactive capillary hyperplasia (RCH), followed by multiple masses on the lower lip and gingiva. After periodontal therapy, the masses on the lower lip and the gingiva were removed, and camrelizumab administration was stopped. The pathological result was gingival pyogenic granuloma/granulomatous hemangioma. No new masses were found in the oral cavity during postoperative follow-up. A review of the literature showed that RCH is the most common adverse drug reaction to camrelizumab but it occurs infrequently in the oral cavity. At present, the etiology of RCH has not been clarified, but the research has shown that camrelizumab may trigger tissue proliferation into hemangiomas by activating vascular endothelial cells, and the combined use of camrelizumab is safer than single use. RCH is self-limiting and most cases resolve spontaneously after discontinuation of the drug. If the mass causes dysfunction, surgical excision is feasible. Conclusion Camrelizumab can cause oral and maxillofacial reactive capillary hyperplasia complicated by pyogenic granuloma.

Keywords

• camrelizumab ，
• pd-1 ，
• malignant tumor ，
• immunotherapy ，
• adverse drug reaction ，
• oral cavity ，
• reactive capillary hemangiomas ，
• hemangioma ，
• vascular endothelial cells ，
• pyogenic granuloma，