title: A case of nonfunctioning pituitary carcinoma that responded to temozolomide treatment.
abstract: Pituitary carcinoma is a rare malignancy and is difficult to manage. Pituitary carcinomas commonly produce either PRL or ACTH, but some do not produce pituitary hormones. The alkylating reagent temozolomide (TMZ) was recently shown to be effective as a treatment for pituitary carcinoma. Most of the published reports of TMZ use in pituitary carcinoma cases were against hormone-producing carcinomas. Only a few patients with a nonfunctioning pituitary carcinoma treated with TMZ have been reported. Here we describe our treatment of a patient with nonfunctioning pituitary carcinoma and a background of multiple endocrine neoplasia type 1. The pituitary carcinoma was accompanied by meningeal dissemination with cerebral and L1 spinal bone metastasis. The patient received continuous dosing of TMZ along with external radiation, followed by standard dosing of TMZ. There was an apparent antitumor response seen in MRI. MGMT, an enzyme antagonized by TMZ, was negative in the tumor. The therapeutic efficacy of TMZ and dosing schedules of TMZ in pituitary carcinoma are discussed.
authors.affiliation: First Department of Medicine, Nagasaki University Graduates School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Morokuma
authors.forename: Takao
authors.initials: T
authors.lastname: Ando
authors.forename: Takuya
authors.initials: T
authors.lastname: Hayashida
authors.forename: Ichiro
authors.initials: I
authors.lastname: Horie
authors.forename: Naoko
authors.initials: N
authors.lastname: Inoshita
authors.forename: Fumi
authors.initials: F
authors.lastname: Murata
authors.forename: Ikuko
authors.initials: I
authors.lastname: Ueki
authors.forename: Kan
authors.initials: K
authors.lastname: Nakamura
authors.forename: Misa
authors.initials: M
authors.lastname: Imaizumi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Usa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami