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lüll Temozolomide-induced shrinkage of a pituitary carcinoma causing Cushing s disease--report of a case and literature review Curto L; Torre ML; Ferrau F; Pitini V; Altavilla G; Granata F; Longo M; Hofland LJ; Trimarchi F; Cannavo SScientificWorldJournal 2010[Nov]; 10 (ä): 2132-8Temozolomide (TMZ) is an alkylating chemotherapeutic agent that has recently been used in some cases as a new therapeutic tool for pituitary carcinomas and aggressive pituitary adenomas. In this report, we present the case of effective TMZ treatment in a 42-year-old man with ACTH-secreting carcinoma. The tumor grew progressively over 4 years, from 2.2 to 31.1 cm(3), despite three surgical approaches and gamma-knife treatment. Ki-67 increased from 2 to 18%. An intradural metastasis at the foramen magnum was detected by MRI after the third operation. Thereafter, four cycles of 5-day TMZ administration (200 mg/m(2)/day during the first, and 150 mg/m(2)/day during the following cycles) induced dramatic tumor size reduction (>90%). Clinical conditions improved progressively and, after 17 months from the beginning of TMZ administration, the patient is still alive. The treatment was well tolerated except for a transient thrombocytopenia (grade 4 WHO).|Adenoma/*drug therapy/metabolism[MESH]|Adrenocorticotropic Hormone/metabolism[MESH]|Adult[MESH]|Antineoplastic Agents, Alkylating/therapeutic use[MESH]|Dacarbazine/*analogs & derivatives/therapeutic use[MESH]|Humans[MESH]|Male[MESH]|Pituitary ACTH Hypersecretion/*drug therapy/metabolism[MESH]|Pituitary Neoplasms/*drug therapy/metabolism[MESH]|Temozolomide[MESH]|Treatment Outcome[MESH] |