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 cm3, despite three surgical approaches and γ-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/m2/day during the first, and 150 mg/m2/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).

, , , , , ,
doi.org/10.1100/tsw.2010.210, hdl.handle.net/1765/32819
Erasmus MC: University Medical Center Rotterdam

Curtò, L., Torre, M., Ferrau, F., Pitini, V., Altavilla, G., Granata, F., … Cannavò, S. (2010). Temozolomide-induced shrinkage of a pituitary carcinoma causing cushing's disease - Report of a case and literature review. TheScientificWorldJournal, 10, 2132–2138. doi:10.1100/tsw.2010.210