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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\u2009mm. 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.<\/jats:p>","DOI":"10.1136\/bcr-2019-231464","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T05:15:19Z","timestamp":1574831719000},"page":"e231464","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Development of pyogenic granuloma with strong vascular endothelial growth factor receptor-2 expression during ramucirumab treatment"],"prefix":"10.1136","volume":"12","author":[{"given":"Tatsuya","family":"Ibe","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2165-9475","authenticated-orcid":false,"given":"Yoichiro","family":"Hamamoto","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, National Hospital Organization Nishisaitama-Chuo National Hospital, Tokorozawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikage","family":"Takabatake","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shingo","family":"Kamoshida","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,26]]},"reference":[{"key":"2025082709035305000_12.11.e231464.1","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1001\/jamadermatol.2015.1925","article-title":"Somatic p.T771R KDR (VEGFR2) mutation arising in a sporadic angioma during ramucirumab therapy","volume":"151","author":"Lim","year":"2015","journal-title":"JAMA Dermatol"},{"key":"2025082709035305000_12.11.e231464.2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2000.104520"},{"key":"2025082709035305000_12.11.e231464.3","first-page":"110","article-title":"Pyogenic granuloma: a retrospective 10-year analysis of 82 cases","volume":"40","author":"Akamatsu","year":"2015","journal-title":"Tokai J Exp Clin Med"},{"key":"2025082709035305000_12.11.e231464.4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.7181\/acfs.2017.18.1.16","article-title":"Pyogenic granuloma: a retrospective analysis of cases treated over a 10-year","volume":"18","author":"Koo","year":"2017","journal-title":"Arch Craniofac Surg"},{"key":"2025082709035305000_12.11.e231464.5","doi-asserted-by":"crossref","DOI":"10.1001\/archderm.142.7.939-a","article-title":"Gefitinib: a cause of pyogenic granulomalike lesions of the nail","volume":"142","author":"High","year":"2006","journal-title":"Arch Dermatol"},{"key":"2025082709035305000_12.11.e231464.6","first-page":"262","article-title":"Paclitaxel-associated subungual pyogenic granuloma: report in a patient with breast cancer receiving paclitaxel and review of drug-induced pyogenic granulomas adjacent to and beneath the nail","volume":"11","author":"Paul","year":"2012","journal-title":"J Drugs Dermatol"},{"key":"2025082709035305000_12.11.e231464.7","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-09-2068"},{"key":"2025082709035305000_12.11.e231464.8","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1111\/1346-8138.14693","article-title":"Four cases of paradoxical cephalocervical pyogenic granuloma during treatment with paclitaxel and ramucirumab","volume":"46","author":"Watanabe","year":"2019","journal-title":"J Dermatol"},{"key":"2025082709035305000_12.11.e231464.9","doi-asserted-by":"crossref","unstructured":"Wang J , Liu Q , Zhou X , et al . Thymidine kinase 1 expression in ovarian serous adenocarcinoma is superior to Ki-67: a new prognostic biomarker. Tumour Biol 2017;39.doi:10.1177\/1010428317706479","DOI":"10.1177\/1010428317706479"},{"key":"2025082709035305000_12.11.e231464.10","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2012.19"},{"key":"2025082709035305000_12.11.e231464.11","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1080\/10520295.2018.1499962","article-title":"Thymidine kinase-1\/CD31 double immunostaining for identifying activated tumor vessels","volume":"94","author":"Okamura","year":"2019","journal-title":"Biotech Histochem"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:04:01Z","timestamp":1756310641000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11]]},"references-count":11,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11,26]]},"published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1136\/bcr-2019-231464"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231464","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,11]]}}}