title: Treatment of pituitary carcinomas and atypical pituitary adenomas: a review.
abstract: Atypical pituitary adenomas (APAs) are aggressive tumors, harboring a Ki-67 (MIB-1) staining index of 3% or more, and positive immunohistochemical staining for p53 protein, according to the World Health Organization (WHO) classification in 2004. Pituitary carcinomas (PC) usually develop from progressive APAs and predominantly consist of hormone-generating tumors, defined by the presence of disseminations in the cerebrospinal system or systemic metastases. Most of the cases with these malignant pituitary adenomas underwent surgeries, irradiations and adjuvant medical treatments, nevertheless, the therapies are mainly palliative. Recently, the efficacy of temozolomide (TMZ), an orally administered alkylating agent, has been reported as an alternative medical treatment. However, some recent studies have demonstrated a significant recurrence rate after effective response to TMZ. Further clinical and pathological researches of malignant pituitary adenomas will be required to improve the outcome of patients with these tumors.
authors.affiliation: Department of Neurosurgery, Teikyo University.
authors.forename: Toshio
authors.initials: T
authors.lastname: Hirohata
authors.forename: Yudo
authors.initials: Y
authors.lastname: Ishii
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuno
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D000284:Administration, Oral; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D002471:Cell Transformation, Neoplastic / Q000187:drug effects / Q000473:pathology; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D010902:Pituitary Gland / Q000473:pathology; D010907:Pituitary Hormones / Q000378:metabolism; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D010907:Pituitary Hormones; D003606:Dacarbazine; D000077204:Temozolomide