Treatment of an Aggressive Gonadotroph Pituitary Neuroendocrine Tumor With 177 Lutetium DOTATATE Radionuclide Therapy.
Autor: | Gandhi C; Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada., Koumna S; Department of Radiology and Diagnostic Imaging, Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada., Chik C; Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada. |
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Jazyk: | angličtina |
Zdroj: | JCEM case reports [JCEM Case Rep] 2024 Jul 15; Vol. 2 (7), pp. luae123. Date of Electronic Publication: 2024 Jul 15 (Print Publication: 2024). |
DOI: | 10.1210/jcemcr/luae123 |
Abstrakt: | Aggressive pituitary neuroendocrine tumors (PitNETs) present significant morbidity, and multimodal therapies including surgery, radiotherapy, and medications are frequently required. Chemotherapy, particularly temozolomide, is often pursued for tumors that progress despite these treatments. Although peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogs is approved for the treatment of well-differentiated gastrointestinal neuroendocrine tumors, its use in aggressive PitNETs is limited. We describe the case of a 65-year-old man who presented with vision changes and hypopituitarism at age 33 secondary to a nonfunctioning gonadotroph PitNET. His initial treatment included a craniotomy followed by radiation therapy. With tumor regrowth, he required transsphenoidal surgeries at age 44 and age 52. At age 56, further tumor regrowth and a positive octreotide scan prompted treatment with long-acting octreotide for 1 year. Given absent tumor response, 12 cycles (4 treatment cycles and 8 maintenance cycles) of PRRT with 177 Lutetium-DOTATATE were pursued. This resulted in partial response with significant tumor shrinkage. Notably, there was no tumor regrowth 40 months after treatment discontinuation. This is only the second report on the effectiveness of PRRT in patients with aggressive gonadotroph PitNETs. We also provide an overview of PRRT for PitNETs and describe clinical outcomes previously reported in the literature. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.) |
Databáze: | MEDLINE |
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