Effect of Temozolomide in a patient with recurring oncocytic gonadotrophic pituitary adenoma

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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.

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Syro, L. V., Scheithauer, B. W., Ortiz, L. D., Fadul, C. E., Horvath, E., Rotondo, F., & Kovacs, K. (2009). Effect of Temozolomide in a patient with recurring oncocytic gonadotrophic pituitary adenoma. Hormones, 8(4), 303–306. https://doi.org/10.14310/horm.2002.1247

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