1: AJR Am J Roentgenol. 2003 Jan;180(1):129-34. Related Articles, Links
Effects of tamoxifen on hepatic fat content and the development of hepatic steatosis in patients with breast cancer: high frequency of involvement and rapid reversal after completion of tamoxifen therapy.
Nishino M, Hayakawa K, Nakamura Y, Morimoto T, Mukaihara S.
Department of Radiology, Kyoto City Hospital, 1-2 Higashi-takada-cho, Mibu, Nakagyo-ku, Kyoto 604-8845, Japan.
OBJECTIVE: A study was conducted on hepatic fat content to investigate the frequency and clinical course of hepatic steatosis induced by tamoxifen. MATERIALS AND METHODS: Sixty-seven patients with breast cancer treated with adjuvant tamoxifen were included. The patients underwent postoperative annual abdominal CT, both with and without contrast enhancement, for 5 years. We retrospectively reviewed unenhanced CT images and obtained hepatic and splenic CT attenuation values to calculate the liver-spleen ratio. Hepatic steatosis was defined as a liver-spleen ratio of less than 0:9, and its degree was classified as mild (liver-spleen ratio, 0:5-0:9), moderate (0-0:5), or severe (<0). The pattern of steatosis was classified as generalized, lobar, segmental, or focal. RESULTS: In the study population, hepatic CT values decreased during therapy (p < 0.0001, t test) and increased after therapy (p < 0.0001, paired t test). Twenty-nine patients (43.2%) developed hepatic steatosis within the first 2 years; its degree was mild in 16, moderate in nine, and severe in four. Seventeen patients showed a generalized pattern of steatosis, and the other 12 showed a lobar pattern. Twenty-three of these patients showed an increase in the liver-spleen ratio after therapy to within the normal range, with a mean recovery time of 1.2 years after therapy ended. None progressed to steatohepatitis or cirrhosis. CONCLUSION:
Tamoxifen had a statistically significant influence on hepatic fat content and was associated with frequent development of hepatic steatosis. Radiologists should be aware of this phenomenon and the possible occurrence of hepatic dysfunction and should differentiate steatosis from metastasis in postoperative patients with breast cancer.
Gastroenterol Hepatol. 2002 Apr;25(4):247-50. Related Articles, Links
[Toxic hepatitis associated with tamoxifen use. A case report and literature review]
[Article in Spanish]
Lasso De La Vega MC, Zapater P, Such J, Sola-Vera J, Paya A, Horga JF, Perez-Mateo M.
Unidad de Farmacologia Clinica, Hospital General Universitario de Alicante, Spain.
[email protected]
Tamoxifen is an antiestrogenic drug that acts by binding to the estrogen receptor. The drug is used as a co-adjuvant treatment in advanced breast cancer expressing the oestrogen-receptor protein. Clinical trials of tamoxifen have shown its efficacy in reducing mortality and recurrence rates over a five-year treatment. Cases of tamoxifen-associated hepatotoxicity have been described, including cholestasis with or without cytolysis and steatohepatitis. We report the case of a female patient who developed hepatic alterations while undergoing continuous tamoxifen treatment. We also present an overview of similar cases published to date and comment on the advisability of continuing or suppressing this treatment in patients with hepatotoxicity or after a five-year treatment period.
J Hepatol. 1995 Jul;23(1):95-7. Related Articles, Links
Tamoxifen-associated steatohepatitis--report of three cases.
Pinto HC, Baptista A, Camilo ME, de Costa EB, Valente A, de Moura MC.
Department of Medicine, University Hospital Santa Maria, Lisbon, Portugal.
The authors describe three cases of tamoxifen-associated steatohepatitis, which resulted from a daily dosage of 20 mg used as the adjuvant treatment of breast carcinoma. Liver tests became normal after discontinuation of tamoxifen.
Of course these women were not also using anabolic steroids....