title: Anti-VEGF therapy in pituitary carcinoma.
abstract: We report the case of a 44-year-old male patient with an aggressive silent corticotroph cell pituitary adenoma, subtype 2. In that it progressed to carcinoma despite temozolomide administration, anti-VEGF therapy was begun. MRI, PET scan and pathologic analysis were undertaken. After 10 months of anti-VEGF (bevacizumab) treatment no progression of the lesion was noted. The tumor was biopsied and morphological analysis showed severe cell injury, vascular abnormalities and fibrosis. Bevacizumab treatment has continued for additional 16 months to present with stabilization of disease as documented on serial MRI and PET scans. This is the first case of a bevacizumab-treated pituitary carcinoma with long-term, now 26 months, control of disease. The present findings are promising in that anti-angiogenic therapy appears to represent a new option in the treatment of aggressive pituitary tumors.
authors.affiliation: Division of Neuro-Oncology, Instituto de Cancerologia, Clinica Las Americas, Medellin, Colombia.
authors.forename: Leon D
authors.initials: LD
authors.lastname: Ortiz
authors.forename: Luis V
authors.initials: LV
authors.lastname: Syro
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Scheithauer
authors.forename: Ayca
authors.initials: A
authors.lastname: Ersen
authors.forename: Humberto
authors.initials: H
authors.lastname: Uribe
authors.forename: Camilo E
authors.initials: CE
authors.lastname: Fadul
authors.forename: Fabio
authors.initials: F
authors.lastname: Rotondo
authors.forename: Eva
authors.initials: E
authors.lastname: Horvath
authors.forename: Kalman
authors.initials: K
authors.lastname: Kovacs
mesh_terms: D049913:ACTH-Secreting Pituitary Adenoma / Q000188:drug therapy*; D000236:Adenoma / Q000188:drug therapy*; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology; D049268:Positron-Emission Tomography; D000077204:Temozolomide; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D003606:Dacarbazine; D000077204:Temozolomide