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Vasculitis associated with nonhematological malignancies.

Zeynep Hande Turna¹

¹Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Medical Oncology Department, Istanbul, Turkey.

Current Opinion in Rheumatology

|December 4, 2025

Summary

Vasculitis can signal underlying cancer and may also be caused by cancer treatments like immune checkpoint inhibitors (ICIs). Early recognition and management are crucial for both conditions.

Keywords:

central nervous system vasculitis immune check-point inhibitors immune related adverse events leukocytoclastic vasculitis paraneoplastic vasculitis

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Area of Science:

Oncology
Rheumatology
Immunology

Background:

The relationship between nonhematological malignancies and vasculitis is intricate.
Paraneoplastic vasculitis presents diversely, with increased cancer risk in some vasculitis patients.
Immune checkpoint inhibitors (ICIs) used for solid tumors can induce vasculitis.

Purpose of the Study:

To review the complex associations between vasculitis and nonhematological malignancies.
To discuss vasculitis induced by immune checkpoint inhibitors (ICIs).

Main Methods:

Literature review of paraneoplastic vasculitis and ICI-induced vasculitis.
Analysis of clinical presentations, timing, and associations with solid tumors.

Main Results:

Vasculitis is less common with solid tumors than hematological malignancies.
Cutaneous leukocytoclastic vasculitis is the most frequent paraneoplastic type, often linked to lung, genitourinary, or gastrointestinal tumors.
ICI-induced vasculitis can affect various vessel sizes and locations, including large vessels, CNS, and small vessels.

Conclusions:

Vigilant monitoring of vasculitis patients aids early cancer detection and guides cancer-specific treatment.
Prompt identification of ICI-induced vasculitis is vital for treatment adjustment (stopping ICIs, initiating immunosuppressives) to prevent severe complications.