All issues > Volume 52(1); 2009

Case Report

Korean J Pediatr. 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 SH Lee¹, Sung Hun SH Noh¹, Sun Young SY Kim¹, Kyu Yun KY Jang², Pyoung Han PH 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

Correspondence Pyoung Han PH 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.

Keywords :Hand-Foot syndrome (HFS), Sorafenib, Renal cell carcinoma