ECE2013 Poster Presentations Clinical case reports – Pituitary/Adrenal (57 abstracts)
Good response to temozolamide therapy in a man with a prolactin secreting pituitary carcinoma
Ismene Bilbao , Mariano Alvarez Coca , Cristina Garcia , Nerea Egana , Maite Aranburu , Alfredo Yoldi , Luisa Antunano & Miguel Goena
Hospital Universitario Donostia, San Sebastian, Spain.
Introduction: Pituitary carcinomas are rare and their management is difficult, because they exhibit a continued growth and metastatic dissemination despite of multimodal and aggressive treatments. Temozolamide, has shown a substantial response rates in pituitary carcinomas.
We report the case of a patient with a malignant prolactinoma successfully treated with temozolamide.
Case report: The patient, a 62-year-old male, consulted with severe headaches. He was diagnosed of a macroprolactinoma but due to poor response to cabergoline and persistence of the headaches, he underwent surgery in 2 ocassions, and was treated with conventional radiotheraphy and cabergoline which allowed control of prolactin, headaches and pituitary remant for a year. By the time that the headaches were back, the prolactin levels showed lack of response to cabergoline and bromocriptine treatment, and he developed hepatic, bronquial and vertebral metastasis.
He was commenced of Temozolamide (200 mg/m2, 5 days every 28 days) for 18 cycles and the prolactin levels responded dramatically, as well as the residual tumor size and the hepatic and bronquial metastasis. He received radiotherapy for the vertebral metastasis and is currently still receiving temozolamide. The treatment has been well tolerated.
Conclusion: Although pituitary carcinoma remains difficult to diagnose and manage, it seems that Temozolamide, an orally administered alkylating agent, may be an effective option for pituitary carcinomas.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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