[Anti-angiogenic therapy of a renal angiomyolipoma in a seriously disabled patient suffering from multiple sclerosis].
BACKGROUND
Angiomyolipoma, although rare, belong together with oncocytomas to the most common benign renal neoplasms. Although angiomyolipoma is usually a non-invasive tumor that does not metastasize, chirurgical intervention, especially in case of large or enlarging tumors, is recommended due to their capacity to cause haemorrhage and other significant clinical complications.


METHODS
We report the case of a renal angiomyolipoma in a female patient seriously disabled by multiple sclerosis with reduced physical and nutritional condition. The woman already underwent a nephrectomy 20 years ago due to an angiomyolipoma of the opposite kidney. The patient received oral gefitinib at a dose of 500 mg/day for 28 days. By a four-weekly course of EGFR-inhibitor gefitinib (Iressa), we achieved a control of the angiomyolipoma and were able to prevent nephrectomy.


CONCLUSIONS
The use of EGFR inhibitors, whose anti-proliferative activity in renal cell tumors derives not only from direct inhibition of cell proliferation, but also from the inhibition of angiogenesis, requires further investigation.
Schroeder
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Klinik für Hämatologie, Onkologie und Klinische Immunologie, Medizinische Klinik II, St. Johannes Hospital, Duisburg, Germany. v.lohrbacher@katholisches-klinikum.de
Aul
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D000284:Administration, Oral; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D018207:Angiomyolipoma / Q000188:drug therapy* / Q000601:surgery; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D016609:Neoplasms, Second Primary / Q000188:drug therapy*; D009392:Nephrectomy; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib