[A case of fatal clinical course with reversible acute cardiac failure and glucose intolerance during sorafenib therapy for metastatic renal cell carcinoma].
A 72-year-old man was diagnosed with right renal cell carcinoma (RCC) with multiple brain and lung metastases (cT3aN0M1). He underwent γ-knife treatment for brain metastases, palliative right renal artery embolization for primary RCC, and interferon- alpha treatment for residual lung metastases. Although the interferon-alpha treatment was effective, it was discontinued because of side effects. He received sorafenib (800 mg/daily) therapy for 2 months. Suddenly, he developed left cardiac failure, and he died 6 days later through a rapid clinical course that included circulatory failure, abnormal glucose tolerance, disseminated intravascular coagulation, and multiple organ failure. A pathological examination could not explain the cause of death. It is important to carefully observe metastatic RCC patients receiving a tyrosine kinase inhibitor, especially sorafenib, because critical side effects may appear.
The Department of Urology, Hitachi General Hospital.
Tomokazu
T
Kimura
Takahiro
T
Suetomi
Tomoaki
T
Miyagawa
Masakazu
M
Tsutsumi
D000208:Acute Disease; D000368:Aged; D000970:Antineoplastic Agents; D001557:Benzenesulfonates / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D018149:Glucose Intolerance / Q000139:chemically induced*; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011725:Pyridines / Q000009:adverse effects*; D000077157:Sorafenib
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib; D011505:Protein-Tyrosine Kinases