NUMERO: #20260420

Título: When Toxicity Mimics Infection: Severe Mucocutaneous Ulcerations and Vasculitis Induced by Atezolizumab-Bevacizumab

Nome do Apresentador: Alysson Luís Santos ZUZARTE

Categoria do Trabalho: Pôster - Relato de Caso ou Série de Casos

Área Temática: Oncologia

Resumo: Immune checkpoint inhibitors combined with antiangiogenic agents have significantly improved outcomes in hepatocellular carcinoma but are associated with complex and sometimes severe adverse events. We report a 65-year-old male with advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab who developed painful ulcerative lesions involving the oral mucosa, lower limb, and penile region. Clinically, the oral lesions presented as multiple ulcers of variable depth, covered by pseudomembranes and surrounded by erythematous halos, initially raising suspicion for viral infection. However, serological tests for HSV, CMV, EBV, and syphilis were negative. Supportive management included antimicrobial photodynamic therapy and topical corticosteroid mouthwashes. Incisional biopsies revealed necrotizing vasculitis in the skin and nonspecific ulceration in the oral mucosa, suggesting treatment-related toxicity. Despite intervention, the patient experienced rapid clinical deterioration and died within two months. This case highlights the potential for severe immune- and vascular-mediated toxicities and underscores the importance of multidisciplinary management and early recognition.

Autor 1:  Alysson Luís Santos ZUZARTE

E-mail 1:  [email protected]

Autor 2:   Helena Carla GONÇALVES dos Santos

E-mail 2:  [email protected]

Autor 3 :  Fernanda Das Neves LOPES

E-mail 3:  [email protected]

Autor 4:  Laura Damato BEMFEITO Barroso

E-mail 4:  [email protected]

Autor 5:  Fábio de Abreu ALVES

E-mail 5:  [email protected]

Autor 6:  Graziella Chagas JAGUAR

E-mail 6:  [email protected]