Acalculous Cholecystitis in a Patient with Metastatic Renal Cell Carcinoma Treated with Sunitinib

Gomez-Abuin, Gonzalo; Karam, A.; Mezzadri, Norberto A; Bas, Carlos

doi:10.3816/cgc.2009.n.011

Cited by 29 publications

(16 citation statements)

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“…A common clinical feature of sunitinib-related acute cholecystitis in three cases including our patient and the previous two cases [2,3] was acalculous cholecystitis while gallbladder stones have been found in 90% of patients with acute cholecystitis [5]. On the other hand, sunitinib causes vascular adverse events by vascular endothelial dysfunction [6,7] resulting in myocardial ischemia [8] and proteinuria due to renal thrombotic microangiopathy [9].…”

Section: Discussionmentioning

confidence: 83%

“…In the literature, sunitinib-related acute cholecystitis has been reported in only two other patients, one with GIST [2] and the other with RCC (clear cell subtype) [3]. We evaluated whether or not acute cholecystitis in our patient was caused by sunitinib with the use of the Naranjo scale [4] which assesses the probability of a drug-related adverse event [2,3]. Its scale score for our patient was five (Table 1), indicating a probable association of acute cholecystitis with sunitinib.…”

Section: Discussionmentioning

confidence: 99%

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Life-threatening acute acalculous cholecystitis in a patient with renal cell carcinoma treated by sunitinib: a case report

2012

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IntroductionSunitinib, an oral multitargeted tyrosine kinase inhibitor, is widely used in the treatment of renal cell carcinoma and gastrointestinal stromal tumor and has had a variety of adverse events. However, sunitinib-related acute cholecystitis has been reported in only two patients with gastrointestinal stromal tumor and renal cell carcinoma (clear cell subtype).Case presentationA 75-year-old Japanese woman with a right sided abdominal swelling was referred to our hospital. Computed tomography (CT) showed a hypervascular bulky tumor in her right kidney, suggesting right renal cell carcinoma in clinical T4N0M0. Although sunitinib therapy was started as neoadjuvant chemotherapy, during the fourth week of the first cycle, she developed acute acalculous cholecystitis and disseminated intravascular coagulation associated with sunitinib. Sunitinib therapy was discontinued immediately and she recovered after subsequent treatment with antibiotics and gabexate mesilate followed by percutaneous cholecystostomy. Cholecystectomy and right radical nephrectomy were performed and pathological examination showed that her renal tumor was a chromophobe renal cell carcinoma (pT2) with necrosis. Inflammation and ischemia were observed in the gallbladder wall, which was compatible with acute acalculous cholecystitis. There has been no evidence of disease recurrence for more than six months.ConclusionWe described the third case of sunitinib-related acute cholecystitis in a patient with chromophobe renal cell carcinoma. Attention is required to sunitinib-related acute cholecystitis which, while uncommon, could be life-threatening.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Life-threatening acute acalculous cholecystitis in a patient with renal cell carcinoma treated by sunitinib: a case report

2012

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“…In the previous literature, only three cases of sunitinib-related acute cholecystitis have been reported, including one patient with a GIST [3] and two patients with RCC [4, 5]. The Naranjo adverse drug reaction probability scale scores for these events were 6 and 5, respectively, indicating the probable association of these events with sunitinib treatment [6].…”

Section: Discussionmentioning

confidence: 99%

Acute Acalculous Cholecystitis in Patients With Clear Cell Renal Cell Carcinoma Treated With Sunitinib: Report of Two Cases

et al. 2014

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Although sunitinib is associated with a variety of adverse events, cases of sunitinib-related acute cholecystitis have rarely been reported. We herein report two cases of sunitinib-related acute acalculous cholecystitis in patients with clear cell renal cell carcinoma. In both cases, the gallbladder was surgically removed because it was difficult to improve the patient’s condition with the cessation of sunitinib and non-surgical treatment only. Attention must be paid to the possibility of sunitinib-related acute cholecystitis, which, although uncommon, can be life-threatening.

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“…There may be an increased incidence of acute acalculous cholecystitis. There have already been two reports of acalculous cholecystitis in patients treated with sunitinib, which is an angiogenesis inhibitor like sorafenib [5, 6], suggesting the potential for such events to occur with sorafenib.…”

Section: Discussionmentioning

confidence: 99%

Acalculous Cholecystitis in a Patient with Hepatocellular Carcinoma on Sorafenib

Sanda

Tamai

Deguchi

et al. 2011

ISRN Gastroenterology

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A 67-year-old woman with compensated cirrhosis type B associated with hepatocellular carcinoma was started on sorafenib for multiple pulmonary metastases. The patient developed right upper quadrant pain and high fever 4 weeks later. Imaging revealed marked enlargement of the gallbladder without calculi. Following percutaneous transhepatic gallbladder aspiration, her symptoms resolved, but the gallbladder remained enlarged. Laparoscopic cholecystectomy was performed. Arteriolar occlusion with intimal thickening in the muscular layer of the gallbladder was seen sporadically. The fact that this patient had no risk factors for acalculous cholecystitis suggested that the cholecystitis resulted from ischemia, implying a strong causal relationship with sorafenib.

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Acalculous Cholecystitis in a Patient with Metastatic Renal Cell Carcinoma Treated with Sunitinib

Cited by 29 publications

References 4 publications

Life-threatening acute acalculous cholecystitis in a patient with renal cell carcinoma treated by sunitinib: a case report

Life-threatening acute acalculous cholecystitis in a patient with renal cell carcinoma treated by sunitinib: a case report

Acute Acalculous Cholecystitis in Patients With Clear Cell Renal Cell Carcinoma Treated With Sunitinib: Report of Two Cases

Acalculous Cholecystitis in a Patient with Hepatocellular Carcinoma on Sorafenib

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