苏尼替尼是肾细胞癌患者常用的治疗药物，但也伴有严重的副作用。我们首次报道了一例使用苏尼替尼治疗患者出现的反复下颌颌下瘘管。一名68岁的男性患者因右侧下颌部皮肤瘘管而被转诊至我院。该患者2年前已确诊为肾癌骨转移，并接受了一次4毫克的左氮芥酸钠注射治疗，随后连续4周以每日37.5毫克的苏尼替尼治疗。我们对该患者进行了围切口手术，并采用缝合法进行初期闭合，同时给予克林霉素等抗菌药物，并嘱咐患者注意口腔卫生。在重新开始苏尼替尼治疗后，皮肤瘘管再次出现，并在X光检查中发现骨异常。经过18个月，观察到对侧面的皮肤瘘管，同时患者左侧磨牙齿自发脱落。再次进行手术治疗和坏死骨剥蚀术后，病理学检查显示怀疑为颌骨坏死并相关的放线菌感染。

Sunitinib is commonly used in the treatment of patients with renal cell carcinoma and is associated with serious side-effects. We present the first report of a recurrent submandibular fistula in a patient treated with sunitinib. A 68-year-old man was referred to our clinic for a cutaneous fistula situated on the right side of his lower jaw. The patient had been diagnosed with bone metastases from a renal carcinoma 2 years ago and had received a single 4 mg dose of zoledronic acid and subsequent treatment with sunitinib 37.5 mg once daily for the past 4 weeks. The patient was treated surgically by a perilesional incision and primary closure with sutures, advised on meticulous oral hygiene and was kept on an antimicrobial agent in the form of clindamycin. After reinitiating his oncological treatment with sunitinib the cutaneous fistula re-appeared and bone abnormalities were also detected on his X-ray. After 18 months a contralateral cutaneous fistula was observed along with a spontaneous avulsion of the patient's left molar. Repeat surgical treatment and sequestrectomy was performed with the subsequent histopathological examination revealing a suspicion of osteonecrosis of the jaw and an associated Actinomyces infection.