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Hand-Foot syndrome induced by sorafenib, a multitargeted tyrosine kinase inhibitor, in a patient with advanced renal cell carcinoma

Korean Journal of Pediatrics 2009;52(1):119-123.
Published online January 15, 2009.
Hand-Foot syndrome induced by sorafenib, a multitargeted tyrosine kinase inhibitor, in a patient with advanced renal cell carcinoma
Seung Hyun Lee1, Sung Hun Noh1, Sun Young Kim1, Kyu Yun Jang2, Pyoung Han Hwang1
1Department of Pediatrics, Research Institute of Clinical Medicine, School of Medicine, Chonbuk National University, Jeonju, Korea
2Department of Pathology, Research Institute of Clinical Medicine, School of Medicine, Chonbuk National University, Jeonju, Korea
진행된 신세포암 환아에게 sorafenib 투여시 발생한 Hand-Foot syndrome 1예
이승현1, 노성훈1, 김선영1, 장규윤2, 황평한1
1전북대학교 의학전문대학원 소아과학교실
2전북대학교 의학전문대학원 병리학교실
Correspondence: 
Pyoung Han Hwang, Email: hwaph@chonbuk.ac.kr.
Abstract
Renal cell carcinoma (RCC) arising from epithelial cells of the renal tubules is a highly aggressive and malignant tumor in all ages; however, it rarely occurs in children. the standard treatment for RCC is radical nephrectomy with lymph node dissection when the tumor is localized and can be completely resected. Adjuvant chemotherapy, radiotherapy, and immunotherapy are used for pediatric patients with advanced RCC involving lymph nodes or metastatic lesions. Sorafenib is an oral, multikinase inhibitor that has recently been approved for use in metastatic RCC. Common toxicities that have been reported include dermatologic changes such as rash or desquamation and hand-foot skin reaction, diarrhea, fatigue, alopecia, and hypertension. In particular, hand-foot syndrome (HFS) an erythematous skin lesion of the palms and solesis most often caused by cytostatic chemotherapeutic agents. In this report, we have studied a 14-year-old female patient with hand-foot syndrome that occurred in association with sorafenib for the treatment of metastatic RCC. Furthermore, this case demonstrates that reversal of complications can be achieved by discontinuing the drug and intervention with topical steroids, vitamin E, and high-dose pyridoxine.
Key Words: Hand-Foot syndrome (HFS), Sorafenib, Renal cell carcinoma


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