everolimus

北海道歯学会

北海道歯学雑誌

Everolimus is a molecularly targeted drug for mammalian target of rapamycin （mTOR）. mTOR is related angiogenesis, the proliferation of normal cells include T-cells and cancer cells. Everolimus is treated with anti-cancer and immunosuppressive drugs. However, it triggers wound healing failure and post-surgery hemorrhage because of anti-angiogenesis and inhibition of cell proliferation. A 74-year-old male patient diagnosed with left renal cell carcinoma and multiple pulmonary metastases was treated with sunitinib. His right lower cuspid and first premolar had been extracted by a dental practitioner after the discontinuation of sunitinib. Everolimus started 22 days after the extraction. Hemorrhage from right lower cuspid and first premolar sockets occurred after a meal 31 days after the extraction. He was referred to our hospital because the hemorrhage continued. Initial examination revealed a lot of clots in his mouth and venous hemorrhage from the sockets. We performed curettage of the sockets and hemostatic treatment to stop the hemorrhage, and then we achieved hemostasis. Because wound healing was delayed, Everolimus was discontinued 5 days after the curettage and hemostatic treatment. The sockets were epithelialized within 33 days after the curettage and hemostatic treatment. We suggest that patients treated with Everolimus require attention to sudden post-operation hemorrhage due to wound healing failure until the wound is epithelialized.