Tamoxifen for the treatment of polycystic liver disease

Autor: M. P. Van Den Berg, Sophie E. Aapkes, Ron T. Gansevoort, Joost P.H. Drenth, Lucas H P Bernts
Přispěvatelé: Groningen Kidney Center (GKC), Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Liver Diseases/diagnosis
Antineoplastic Agents
Hormonal/therapeutic use
medicine.drug_class
medicine.medical_treatment
Antineoplastic Agents
Cysts/diagnosis
Liver transplantation
Gastroenterology
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
Breast cancer
All institutes and research themes of the Radboud University Medical Center
Internal medicine
Medicine
Humans
Cyst
Hormonal/therapeutic use
Tomography
business.industry
Polycystic liver disease
General Medicine
Middle Aged
medicine.disease
X-Ray Computed
Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11]
Tamoxifen/therapeutic use
Estrogen
Female
Liver function
business
Tomography
X-Ray Computed
Tamoxifen
medicine.drug
Rare disease
Follow-Up Studies
Zdroj: Medicine (Baltimore), 100
Medicine (Baltimore), 100, 32
Medicine, 100(32):e26797. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 0025-7974
Popis: RATIONALE: Polycystic liver disease is a rare disease characterized by the growth of numerous cysts in the liver. The liver function remains well preserved, but liver volumes can grow very large, and some patients ultimately need a liver transplantation. Other treatment options are limited and there is an unmet need for new therapeutic options.PATIENT CONCERNS: We describe a 59-year-old patient with pain in the abdomen, especially when bending forward. Five years ago, she was diagnosed with breast cancer and as an incidental finding a couple of large liver cysts were diagnosed, explaining her abdominal pain.DIAGNOSIS: Polycystic liver disease with several large liver cysts.INTERVENTIONS: The patient was treated with tamoxifen, an estrogen receptor modulator, as treatment for her hormone receptor positive breast cancer. One of the liver cysts was aspirated.OUTCOMES: In the 4.6 years after the start of tamoxifen treatment, 20 mg once daily, the volume of her liver cysts decreased remarkably. There was a reduction of combined cyst volume from 311 mL to 22 mL without percutaneous drainage.LESSONS: Epidemiological as well as experimental evidence supports a pivotal role for estrogens as a driver for growth of polycystic livers. Estrogen antagonism has often been proposed as a therapeutic target, but supporting evidence is lacking in the literature. We hypothesize that the decrease in cyst size in this patient was caused by tamoxifen therapy, suggesting an in vivo antagonistic effect on cystic cholangiocytes. This is an important finding because tamoxifen could be a promising new treatment option for polycystic liver disease.
Databáze: OpenAIRE
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