Case Report

Yellow Skin Discoloration Associated with Sorafenib Use for Treatment of Metastatic Renal Cell Carcinoma

Authors: Constantin A. Dasanu, MD, PhD, Janice Dutcher, MD, Doru T. Alexandrescu, MD


This report describes a patient with metastatic kidney cancer who developed a deep yellow skin discoloration while on therapy with the oral multitargeted tyrosine kinase inhibitor (TKI), sorafenib. A significant hand-foot syndrome, featuring acral skin desquamation and tender erythema at pressure points, was also present. A thorough clinicolaboratory investigation did not reveal any evidence of jaundice, B12 deficiency, anemia, carotenemia, hypothyroidism, or any other disorder of endocrine or metabolic etiology.

Key Points

* Yellow skin discoloration represents a probable side effect of sorafenib.

* With increasing use of multitargeted TKIs in the setting of various malignancies, physicians should be aware of this new entity.

* The awareness of sorafenib- and sunitinib-induced yellow skin discoloration is important for patient reassurance and avoidance of unnecessary diagnostic workup.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Robert C, Soria JC, Spats A, et al. Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005;6:491–500.
2. Motzer RJ, Michaelson MD, Redman BG, et al. Activity of SU11248, a multitargeted inhibitor of vascular endothelial growth factor receptor and platelet-derived growth factor receptor, in patients with metastatic renal cell carcinoma. J Clin Oncol 2006;24:16–24.
3. Faivre S, Delbaldo C, Vera K, et al. Safety, pharmacokinetic, and antitumor activity of SU11248, a novel oral multitarget tyrosine kinase inhibitor, in patients with cancer. J Clin Oncol 2006;24:25–35.
4. Sorafenib Monograph. DrugDex in Micromedex Healthcare Series. Accessed July 2, 2006.
5. Ahmad T, Eisen T. Kinase inhibition with BAY 43-9006 in renal cell carcinoma. Clin Cancer Res 2004;10:6388S–6392S.
6. Ratain MJ, Eisen T, Stadler WM, et al. Phase II placebo-controlled randomized discontinuation trial of sorafenib in patients with metastatic renal cell carcinoma. J Clin Oncol 2006;24:2505–2512.
7. Arya V, Grzybowski J, Schwartz RA. Carotenemia. Cutis 2003;71:441–442.
8. Roche SP, Kobos R. Jaundice in the adult patient. Am Fam Physician 2004;69:299–304.
9. Aktuna D, Buchinger W, Lansteger W, et al. Beta-carotene, vitamin A and carrier proteins in thyroid diseases. Acta Med Austriaca 1993;20:17–20.
10. Chitturi S, Dakkak M, Campbell AP. Skin fragility and abnormal liver function tests. Postgrad Med J1999;75:435–437.
11. Kong MF, Jeffcoate W. Eighty-six cases of Addison's disease. Clin Endocrinol (Oxf) 1994;41:757–761.
12. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239–245.