case_images: PMC10715407_01
case_images: The timeline of patient progress throughout treatment.
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case_images: The timeline of the patient's entire treatment progress is shown in  Figure 1 .
case_images: Dark red nodules were distributed over the patient's head, face, and trunk. (A, C) Before surgery. (B, D) After surgery. (C) Before surgery, the nodule pulled on the right lower eyelid, resulting in incomplete closure of the right eye. (D) After surgery, the patient could close the right eye normally. (E) Six months after the operation, no recurrence of the right lower eyelid nodule was observed, although new nodules were noted in other parts of the face. (F) Dark red nodules distributed over the patient's trunk before surgery.
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case_images: Some spots gradually developed into pea-sized nodules ( Figure 2 ). Two months later, the nodule on the right lower eyelid had grown to the size of a peanut ( Figure 2 ). In addition, the nodule pulled the lower eyelid downwards, which affected eyelid closure owing to the thin skin and soft tissue of the lower eyelid ( Figures 2A, C ). The patient recovered well postoperatively and was able to close the right eye without difficulty ( Figures 2B, D ). During the 6-month follow-up period, the surgical area of the right lower eyelid had recovered well, without RCCEP recurrence ( Figure 2E ). Because the patient continued to receive camrelizumab postoperatively, dark red nodules remained on other parts of the body ( Figure 2E ); however, these lesions resolved spontaneously after the patient completed 1 year of immunotherapy.
case_images: Head computed tomography (A: transverse plane, B: sagittal plane) shows the relationship between the nodule and surrounding soft tissues (arrows).
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case_images: Head computed tomography revealed a nodule that protruded outward and squeezed the normal eye tissue inward ( Figure 3 ).
case_images: Pathological characteristics of the right lower eyelid nodule. (A) The size of the surgically resected nodule was about 1.5 cm x 1.0 cm x 0.9 cm. (B, (C) Hematoxylin and eosin staining showed extensive capillary proliferation. (B) x 200; (C) x 400.
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case_images: The removed nodule is shown in ( Figure 4A ). Large vessels were surrounded by small vessels; lumens varied in size and contained red blood cells ( Figure 4B ). The nuclei were oval or short and spindle-shaped; mitotic figures were easily observed ( Figure 4C ).