Brief Communication: Tamoxifen Therapy for Nonmalignant Retroperitoneal Fibrosis
- Eric F.H. van Bommel, MD, PhD;
- Tadek R. Hendriksz, MD;
- Antonius W.L.C. Huiskes, MD; and
- Antoine G.M. Zeegers, MD
Abstract
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.
Article and Author Information
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Acknowledgment: The authors thank A.J.M. Cleophas, MD, PhD, and C. Siemes, MD, for their statistical advice.
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Grant Support: None.
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Potential Financial Conflicts of Interest: None disclosed.
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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.
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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.
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Author Contributions: Conception and design: E.F.H. van Bommel.
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Analysis and interpretation of the data: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes, A.G.M. Zeegers.
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Drafting of the article: E.F.H. van Bommel.
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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.
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Final approval of the article: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes, A.G.M. Zeegers.
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Statistical expertise: E.F.H. van Bommel.
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Collection and assembly of data: E.F.H. van Bommel, T.R. Hendriksz, A.W.L.C. Huiskes.
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