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BMJ Case Rep. 2019 Nov 26;12(11). pii: e231464. doi: 10.1136/bcr-2019-231464.

Development of pyogenic granuloma with strong vascular endothelial growth factor receptor-2 expression during ramucirumab treatment.

Author information

1
Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Japan.
2
Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Japan hamamoto32@gmail.com.
3
Laboratory of Pathology, Department of Medical Biophysics, Kobe University Faculty of Health Sciences and Graduate School of Medicine Faculty of Health Sciences, Kobe, Hyogo, Japan.

Abstract

The angiogenesis inhibitor ramucirumab (IMC-1121B) is a fully humanised IgG1 monoclonal antibody targeting the extracellular domain of vascular endothelial growth factor receptor 2. Ramucirumab has been approved as a second-line treatment for lung cancer. Pyogenic granuloma is an acquired, benign vascular tumour of the skin or mucous membrane. We encountered a patient with pyogenic granuloma who was treated with ramucirumab. The patient was a 48-year-old Japanese woman with advanced lung cancer who had been heavily pretreated using several lines of chemotherapy. Ramucirumab was administered as the fifth-line treatment with docetaxel. After 10 days, a painless rice-coloured or pink papule appeared on her finger. One month later, it increased in size to 20 mm. We examined the pathological condition by immunostaining using the resected specimen diagnosed as pyogenic granuloma. Paradoxically, this vascular tumour arose during the administration of an angiogenesis inhibitor.

KEYWORDS:

chemotherapy; dermatology; lung cancer (oncology); skin

PMID:
31776151
DOI:
10.1136/bcr-2019-231464
Free PMC Article

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