Brief Communication: Tamoxifen Therapy for Nonmalignant Retroperitoneal Fibrosis

  1. Eric F.H. van Bommel, MD, PhD;
  2. Tadek R. Hendriksz, MD;
  3. Antonius W.L.C. Huiskes, MD; and
  4. Antoine G.M. Zeegers, MD
  1. From Albert Schweitzer Hospital, Dordrecht, the Netherlands.

    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

    • 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.

    Responses to this article

    • tamoxifen for retroperitoneal fibrosis
      • Eric F.H. van Bommel and
      • Tadek R. Hendriksz, MD
      Ann Intern Med published online October 26, 2009
    • Tamoxifen for retroperitoneal fibrosis
      • Augusto Vaglio and
      • Paolo Greco, MD and Carlo Buzio, MD
      Ann Intern Med published online October 26, 2009

    Summary for Patients

    • Summaries for Patients:Tamoxifen for the Treatment of Retroperitoneal Fibrosis Ann Intern Med January 17, 2006 144:I-51
    « Previous | Next Article »Table of Contents

    This Article

    1. Ann Intern Med January 17, 2006 vol. 144 no. 2 101-106
    1. » Abstract
    2. Figures
    3. Full Text
    4. Full Text (PDF)
      1. Summary for Patients

    Current Issue

    1. February 2, 2010, 152 (3)
    1. Alert me to current issues