title: Effect of temozolomide in a patient with recurring oncocytic gonadotrophic pituitary adenoma.
abstract: The patient was a 70-year-old man with a recurrent pituitary tumor. Three surgeries were performed but the tumor recurred. Based on histologic, immunohistochemical and ultrastructural studies, the diagnosis of oncocytic gonadotrophic pituitary adenoma was made. The tumor was a macroadenoma partly immunopositive for LH. Immunohistochemistry for O6 Methylguanine-DNA Methyl-Transferase (MGMT) showed an admixture of immunopositive and immunonegative cells. After recurrence following operations, the patient was treated with Temozolomide, an imidazotetrazine derivative, DNA-alkylating drug. Following Temozolomide administration the MRI demonstrated significant tumor necrosis. A few months later, the patient died of massive pulmonary embolism. No autopsy was performed. The present case indicates that benign, typically slow-growing pituitary adenomas of oncocytic gonadotrophic type may respond to Temozolomide even when the tumor consists of an admixture of MGMT immunopositive and immunonegative cells.
authors.affiliation: Department of Neurosurgery, Clinica Medellin and Hospital Pablo Tobon Uribe, Medellin, Colombia.
authors.forename: Luis V
authors.initials: LV
authors.lastname: Syro
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Scheithauer
authors.forename: Leon D
authors.initials: LD
authors.lastname: Ortiz
authors.forename: Camilo E
authors.initials: CE
authors.lastname: Fadul
authors.forename: Eva
authors.initials: E
authors.lastname: Horvath
authors.forename: Fabio
authors.initials: F
authors.lastname: Rotondo
authors.forename: Kalman
authors.initials: K
authors.lastname: Kovacs
mesh_terms: D000236:Adenoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide