Brief Communication: Tamoxifen Therapy for Nonmalignant Retroperitoneal Fibrosis

17 January 2006 | Volume 144 Issue 2 | Pages 101-106

Background: Anecdotal case reports suggest tamoxifen as a possible treatment for retroperitoneal fibrosis, but a systematic assessment of its effect is not available.

Objective: To describe the course and outcomes of patients with nonmalignant retroperitoneal fibrosis treated with tamoxifen.

Design: Prospective, consecutive series.

Setting: Single tertiary care referral center.

Patients: 19 patients with nonmalignant retroperitoneal fibrosis treated with tamoxifen from April 1998 through April 2005.

Intervention: Tamoxifen, 20 mg orally twice daily.

Measurements: Clinical improvement, laboratory variables, and follow-up computed tomography (CT) and gallium scan findings.

Results: Fifteen patients reported substantial resolution of symptoms after a median treatment duration of 2.5 weeks. Erythrocyte sedimentation rate and C-reactive protein also improved. Gallium scanning at follow-up showed incomplete disappearance of pathologic gallium-67 activity. Repeated CT scanning showed slow but steady mass regression in 14 of 15 clinical responders. Five patients failed treatment, including 1 patient who improved clinically. Disease recurred in 1 patient who responded to reintroduction of tamoxifen. One patient developed reversible hepatitis.

Limitations: This small observational study did not have a control group.

Conclusion: Tamoxifen may be a viable therapeutic option in the treatment of retroperitoneal fibrosis.

Editors' Notes Context There are few effective treatments for retroperitoneal fibrosis. Contribution Of 19 adults with nonmalignant retroperitoneal fibrosis treated with tamoxifen for variable durations of time, 15 reported substantial resolution of symptoms and 14 had computed tomography scans that showed slow regression of retroperitoneal masses. Three men reported minor losses of libido, and 1 patient developed reversible hepatitis. Caution There was no control group in this small observational study. Implications Tamoxifen is a possible therapy for retroperitoneal fibrosis. It should be compared with other treatments in long-term trials. —The Editors

 

Author and Article Information

From Albert Schweitzer Hospital, Dordrecht, the Netherlands.

Acknowledgment: The authors thank A.J.M. Cleophas, MD, PhD, and C. Siemes, MD, for their statistical advice.

Grant Support: None.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Eric F.H. van Bommel, MD, PhD, Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, P.O. Box 444, NL-3300 AK Dordrecht, the Netherlands; e-mail, e.f.h.vanbommel{at}asz.nl.

Current Author Addresses: Dr. van Bommel and Drs. Hendriksz, Huiskes, and Zeegers: Albert Schweitzer Hospital, P.O. Box 444, NL-3300 AK Dordrecht, the Netherlands.

Author Contributions: Conception and design: E.F.H. van Bommel.

Analysis and interpretation of the data: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes, A.G.M. Zeegers.

Drafting of the article: E.F.H. van Bommel.

Critical revision of the article for important intellectual content: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes, A.G.M. Zeegers.

Final approval of the article: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes, A.G.M. Zeegers.

Statistical expertise: E.F.H. van Bommel.

Collection and assembly of data: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes.

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