title: Tonsillar pseudotumor: complications of chronically-administered temozolomide.
abstract: The current standard of care for patients with Glioblastoma multiforme (GBM) is surgery, followed by radiation in combination with Temozolomide (TMZ), followed by adjuvant TMZ. The most appropriate length of treatment of adjuvant TMZ after the completion of radiation is unclear. We present the case of a 45 year old female with GBM who received adjuvant TMZ on an experimental study for 24 1-month cycles (150 mg/M(2) 7 days on/7 days off continuously-a higher TMZ dose than standard). After 24 months on study she was stable without GBM regrowth, but presented with a right tonsil and pharynx mass consistent with a new primary malignancy. Tonsillar biopsy was positive for Epstein-Barr virus, Cytomegalovirus and Herpes Simplex Virus, but no tumor. This case highlights the risks and possible complications of immunosuppression associated with long term TMZ use.
authors.affiliation: Department of Neuro-Oncology, The University of Texas MD Anderson Texas Cancer Center, Houston, TX 77030, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Grisdale
authors.forename: Melesa
authors.initials: M
authors.lastname: Ritterhouse
authors.forename: Kathy
authors.initials: K
authors.lastname: Hunter
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.forename: Morris D
authors.initials: MD
authors.lastname: Groves
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects*; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D014066:Palatine Tonsil / Q000473:pathology*; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide