Temozolomide therapy in a man with an aggressive prolactin-secreting pituitary neoplasm: morphological findings

Kovács, Kálmán; Horváth, Éva; Syro, Luis V.; Uribe, Humberto; Penagos, Luis C.; Ortíz, León Darío; Fadul, Camilo E.

doi:10.1016/j.humpath.2006.07.014

Cited by 98 publications

(97 citation statements)

References 13 publications

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“…There also was a corresponding reduction in mitotic activity (from 11 of 1000 nuclei to 2 of 1000 nuclei). 15 Predictably, in the MGMTpositive, silent, subtype 2 corticotrophic adenoma, no such alterations were produced. 16 Radiographic Changes Three patterns of radiographic change have been observed on MRI images from patients who had a good response to temozolomide treatment.…”

Section: Morphologic Changesmentioning

confidence: 99%

“…15,23 The patient was a man aged 42 years with a PRL-producing adenoma who had undergone 5 previous surgeries. He had received not only radiotherapy but also bromocriptine, pergolide, and cabergoline treatment, and none of those treatments had any effect on the growth of his tumor.…”

Section: Pituitary Adenomasmentioning

confidence: 99%

“…Syro et al 23 and Kovacs et al 15,16 published the only morphologic comparisons of pathology before and after temozolomide treatment. In those studies, operative findings included tumor softening and friability, both of which facilitated resection at reintervention.…”

Section: Morphologic Changesmentioning

confidence: 99%

“…16 Radiographic Changes Three patterns of radiographic change have been observed on MRI images from patients who had a good response to temozolomide treatment. These included tumor necrosis and hemorrhage, 15,23 tumor degenerative and cystic changes, 22 and tumor shrinkage. 2,10,11,14,[19][20][21]24 These changes could be observed as early as 2 months after the onset of temozolomide treatment.…”

Section: Morphologic Changesmentioning

confidence: 99%

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Treatment of pituitary neoplasms with temozolomide

Syro

Ortíz

Scheithauer

et al. 2010

Cancer

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Temozolomide, an orally administered alkylating agent, is used to treat malignant gliomas. Recent reports also have documented its efficacy in the treatment of pituitary adenomas and carcinomas. Temozolomide methylates DNA and thereby exhibits an antitumor effect. O 6 -methylguanine-DNA methyltransferase (MGMT), a DNA repair enzyme, removes alkylating adducts induced by temozolomide, counteracting its effects. The authors of this review conducted a Medline database search regarding temozolomide in the treatment of pituitary tumors. Demographic characteristics, tumor types, and therapeutic responses were noted in all patients. Data regarding MGMT immunoexpression, which was documented in some studies, were correlated with information regarding clinical and radiologic responses. To date, there have been 19 reported cases of adenohypophyseal tumors treated with temozolomide, including 13 adenomas and 6 carcinomas. Ten of those 13 adenomas responded favorably, and 2 nonresponsive tumors had highlevel MGMT immunoexpression. All 6 carcinomas responded to therapy, but data regarding MGMT expression were available for only 3 patients, and each had low MGMT expression. In 2 adenomas, morphologic studies were performed both before and after the patients received temozolomide. The responsive tumor had necrosis, hemorrhage, fibrosis, and neuronal differentiation. The nonresponsive tumor had no changes. There have been no reported complications attributable to temozolomide. The current results indicated that temozolomide is efficacious in the treatment of aggressive pituitary adenomas and pituitary carcinomas. Evidence indicated that low-level MGMT immunoexpression is correlated with a favorable response. A significant proportion of pituitary adenomas and carcinomas had low MGMT immunoexpression. Cancer 2011;117:454-62.

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Section: Morphologic Changesmentioning

confidence: 99%

Section: Pituitary Adenomasmentioning

confidence: 99%

Section: Morphologic Changesmentioning

confidence: 99%

Section: Morphologic Changesmentioning

confidence: 99%

See 2 more Smart Citations

Treatment of pituitary neoplasms with temozolomide

Syro

Ortíz

Scheithauer

et al. 2010

Cancer

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“…Most carcinomas, however, respond poorly (29). Recently, a limited number of aggressive pituitary adenomas and carcinomas resistant to conventional treatment have been reported to respond to temozolomide (TMZ) therapy (Table 1) (30)(31)(32)(33)(34)(35)(36).…”

Section: Introductionmentioning

confidence: 99%

Temozolomide treatment of a pituitary carcinoma and two pituitary macroadenomas resistant to conventional therapy

Schroeder¹,

Hansen

Hagen³

et al. 2009

European Journal of Endocrinology

112

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Objective: Aggressive pituitary tumours may be difficult to treat. Temozolomide (TMZ) is an alkylating cytostaticum. In a small number of cases, TMZ therapy has been reported to reduce pituitary tumour size and hormone hypersecretion. Design: We present three patients with pituitary tumours treated with TMZ. One tumour was initially a macroprolactinoma that developed into a mixed GH-and prolactin-secreting carcinoma (patient A). To our knowledge, this is the first published in English literature. Two adenomas, a macroprolactinoma (patient B) and a clinically non-functioning pituitary adenoma (patient C), were highly invasive. The three patients suffered from extensive tumour mass effects, and all tumours were resistant to conventional treatment. Method: TMZ, 150-200 mg/m 2 of body surface area was administered orally for 5 days during each 28-day cycle. Result: During TMZ therapy, tumour sizes were significantly reduced, hormone levels normalized and symptoms of mass effects decreased in all three cases. The carcinoma was treated from 2004 to 2006 (23 months). Three years after the terminating treatment, the tumour has not regrown and hormone levels are normalized. Immunohistochemical staining for methylguanine DNA methyltransferase (MGMT) was negative in two patients (A and B), and in one patient (C) a few nuclei stained positive. Conclusion: TMZ therapy significantly decreased tumour volume, hormone hypersecretion and symptoms in all three patients, corresponding to the pathological findings regarding MGMT. TMZ therapy may be a new option for the treatment of resistant pituitary adenomas.

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2008

Arthritis & Rheumatism

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Temozolomide therapy in a man with an aggressive prolactin-secreting pituitary neoplasm: morphological findings

Cited by 98 publications

References 13 publications

Treatment of pituitary neoplasms with temozolomide

Treatment of pituitary neoplasms with temozolomide

Temozolomide treatment of a pituitary carcinoma and two pituitary macroadenomas resistant to conventional therapy

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