Brief communication: tamoxifen therapy for nonmalignant retroperitoneal fibrosis

Ann Intern Med. 2006 Jan 17;144(2):101-6. doi: 10.7326/0003-4819-144-2-200601170-00007.

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.

MeSH terms

  • Aged
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Estrogen Antagonists / adverse effects
  • Estrogen Antagonists / therapeutic use*
  • Female
  • Gallium Radioisotopes
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Radionuclide Imaging
  • Retroperitoneal Fibrosis / diagnostic imaging
  • Retroperitoneal Fibrosis / drug therapy*
  • Tamoxifen / adverse effects
  • Tamoxifen / therapeutic use*
  • Treatment Outcome

Substances

  • Estrogen Antagonists
  • Gallium Radioisotopes
  • Tamoxifen
  • C-Reactive Protein