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Brief communication: tamoxifen therapy for nonmalignant retroperitoneal fibrosis
Eric F H van Bommel1, Tadek R Hendriksz, Antonius W L C Huiskes
1Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. e.f.h.vanbommel@asz.nl
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.
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