Temozolomide-Induced Shrinkage of a Pituitary Carcinoma Causing Cushing's Disease — Report of a Case and Literature Review. (2010)

• Record Type: Journal Article
• Authors: Curtò, Lorenzo; Torre, Maria L.; Ferraù, Francesco; Pitini, Vincenzo; Altavilla, Giuseppe; Granata, Francesca; Longo, Marcello; Hofland, Leo J.; Trimarchi, Francesco; Cannavò, Salvatore
• Other Names: Frohman Lawrence A. Academic Editor.
• Is Part Of: TheScientificWorldjournal. Volume 10(2010)
• Page Start: 2132
• Page End: 2138
• Publication Date: 2010
• Subjects: temozolomide -- pituitary carcinoma -- chemotherapy -- O6-methylguanine DNA methyltransferase -- Cushing's disease; Science -- Periodicals; Technology -- Periodicals; Medicine -- Periodicals; 505
• DOI: 10.1100/tsw.2010.210
• Languages: English
• ISSNs: 2356-6140

Abstract

Abstract : Temozolomide (TMZ) is an alkylating chemotherapeutic agent that has recently been used in some cases as a new therapeutic tool for pituitary carcinomas and aggressive pituitary adenomas. In this report, we present the case of effective TMZ treatment in a 42-year-old man with ACTH-secreting carcinoma. The tumor grew progressively over 4 years, from 2.2 to 31.1 cm 3, despite three surgical approaches and gamma-knife treatment. Ki-67 increased from 2 to 18%. An intradural metastasis at the foramen magnum was detected by MRI after the third operation. Thereafter, four cycles of 5-day TMZ administration (200 mg/m 2 /day during the first, and 150 mg/m 2 /day during the following cycles) induced dramatic tumor size reduction (>90%). Clinical conditions improved progressively and, after 17 months from the beginning of TMZ administration, the patient is still alive. The treatment was well tolerated except for a transient thrombocytopenia (grade 4 WHO).