Chen Cheng, Yin Senlin, Zhang Shizhen, Wang Mengmeng, Hu Yu, Zhou Peizhi, Jiang Shu
Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province Department of Neurosurgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China.
Medicine (Baltimore). 2017 Nov;96(47):e8733. doi: 10.1097/MD.0000000000008733.
Aggressive pituitary adenomas and pituitary carcinomas are rare and demand multiple treatment strategies. Temozolomide, an orally active alkylating chemotherapeutic agent, has recently been recommended as a salvage medication for refractory pituitary adenomas or carcinomas.
A 17-year-old male presenting with aggressive prolactinoma that continued to progress despite surgery, gamma knife, and dopamine agonists.
The diagnosis of refractory aggressive prolactinoma was made on the basis of clinical findings and the lack of efficacy of conventional treatment.
The patient received the most frequently recommended regimen of temozolomide treatment for 22 cycles.
Temozolomide resulted in a remarkable shrinkage of tumor mass and inhibition of prolactin secretion and this patient's clinical condition improved progressively.
Temozolomide can be used as a salvage treatment to refractory pituitary tumors and o(6)-methylguanine-DNA methyltransferase (MGMT) status is a significant predictor to the effectiveness of temozolomide based on the existing literature.
侵袭性垂体腺瘤和垂体癌较为罕见，需要多种治疗策略。替莫唑胺是一种口服活性烷化剂化疗药物，最近被推荐作为难治性垂体腺瘤或癌的挽救性药物。
一名17岁男性，患有侵袭性泌乳素瘤，尽管接受了手术、伽玛刀和多巴胺激动剂治疗，但病情仍持续进展。
根据临床表现及传统治疗无效，诊断为难治性侵袭性泌乳素瘤。
患者接受了最常推荐的替莫唑胺治疗方案，共22个周期。
替莫唑胺使肿瘤体积显著缩小，抑制了泌乳素分泌，患者的临床状况逐渐改善。
根据现有文献，替莫唑胺可作为难治性垂体肿瘤的挽救性治疗，且O(6)-甲基鸟嘌呤-DNA甲基转移酶（MGMT）状态是替莫唑胺疗效的重要预测指标。
