A Case of Nonfunctioning Pituitary Carcinoma That Responded to Temozolomide Treatment

Autor: Haruko Morokuma, Takao Ando, Takuya Hayashida, Ichiro Horie, Naoko Inoshita, Fumi Murata, Ikuko Ueki, Kan Nakamura, Misa Imaizumi, Toshiro Usa, Atsushi Kawakami
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: Case Reports in Endocrinology, Vol 2012 (2012)
Druh dokumentu: article
ISSN: 2090-6501
2090-651X
DOI: 10.1155/2012/645914
Popis: Pituitary carcinoma is a rare malignancy and is difficult to manage. Pituitary carcinomas commonly produce either PRL or ACTH, but some do not produce pituitary hormones. The alkylating reagent temozolomide (TMZ) was recently shown to be effective as a treatment for pituitary carcinoma. Most of the published reports of TMZ use in pituitary carcinoma cases were against hormone-producing carcinomas. Only a few patients with a nonfunctioning pituitary carcinoma treated with TMZ have been reported. Here we describe our treatment of a patient with nonfunctioning pituitary carcinoma and a background of multiple endocrine neoplasia type 1. The pituitary carcinoma was accompanied by meningeal dissemination with cerebral and L1 spinal bone metastasis. The patient received continuous dosing of TMZ along with external radiation, followed by standard dosing of TMZ. There was an apparent antitumor response seen in MRI. MGMT, an enzyme antagonized by TMZ, was negative in the tumor. The therapeutic efficacy of TMZ and dosing schedules of TMZ in pituitary carcinoma are discussed.
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