title: Acalculous cholecystitis in a patient with metastatic renal cell carcinoma treated with sunitinib.
abstract: A 62-year-old woman was treated with sunitinib as a second-line therapy for metastatic clear-cell renal carcinoma. She was given oral sunitinib 50 mg once daily, 4 weeks on followed by 2 week off. During the fourth week of her first cycle, the patient was admitted to our hospital because of an acute-onset, right upper quadrant pain associated with nausea and vomiting. She was diagnosed with acute acalculous cholecystitis, which was treated with broad-spectrum antibiotics, and sunitinib therapy was discontinued. A follow-up computed tomography scan of the abdomen revealed a complete resolution of gallbladder changes. Our patient did not have major risk factors for developing an acalculous cholecystitis except for a relative immunosuppressed state secondary to her advanced renal cancer. The Naranjo Adverse Drug Reaction Probability Scale score for this event was 5, indicating a probable association of the event with sunitinib. Because the use of sunitinib is expanding in clinical practice, we want to alert the oncology community about this uncommon and life-threatening complication in patients receiving sunitinib or another agent with antiangiogenic activity.
authors.affiliation: Section of Clinical Oncology, Hospital Alemán, Buenos Aires, Argentina. ggabuin@yahoo.com
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Gomez-Abuin
authors.forename: Aída Amelia
authors.initials: AA
authors.lastname: Karam
authors.forename: Norberto Aristídes
authors.initials: NA
authors.lastname: Mezzadri
authors.forename: Carlos Arturo
authors.initials: CA
authors.lastname: Bas
mesh_terms: D042101:Acalculous Cholecystitis / Q000139:chemically induced* / Q000188:drug therapy; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects*; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib