Long-term control of a MEN1 prolactin secreting pituitary carcinoma after temozolomide treatment

Melanie Philippon; Isabelle Morange; Marilyne Barrie; Anne Barlier; David Taieb; Henry Dufour; Bernard Conte-Devolx; Thierry Brue; Frédéric Castinetti

doi:10.1016/j.ando.2012.03.001

Long-term control of a MEN1 prolactin secreting pituitary carcinoma after temozolomide treatment

Ann Endocrinol (Paris). 2012 Jun;73(3):225-9. doi: 10.1016/j.ando.2012.03.001. Epub 2012 Apr 20.

Authors

Melanie Philippon¹, Isabelle Morange, Marilyne Barrie, Anne Barlier, David Taieb, Henry Dufour, Bernard Conte-Devolx, Thierry Brue, Frédéric Castinetti

Affiliation

¹ Department of endocrinology and reference center for rare pituitary diseases, hôpital Timone, assistance publique hôpitaux de Marseille, Aix-Marseille université, 13284 Marseille, France.

PMID: 22520146
DOI: 10.1016/j.ando.2012.03.001

Abstract

We report here a rare case of a young male patient presenting with a Multiple Endocrine Neoplasia Type 1 - prolactin-secreting pituitary carcinoma, controlled long-term after temozolomide withdrawal. Initial presentation was pituitary apoplexy leading to surgery. Dopamine agonists and radiotherapy allowed control of prolactin secretion and pituitary remnant. Metastasis appeared 10 years after initial presentation, leading to the diagnosis of pituitary carcinoma. At that time, dopamine agonists were no more effective; temozolomide, an oral alkylating agent, was administered for 24 cycles, and allowed decrease of the volume of the pituitary lesion and metastases. The patient is still currently followed in our department, 3 years after temozolomide withdrawal: prolactin level and pituitary tumor volume remain controlled without any chemotherapy. To our knowledge, this is the first case of MEN1 prolactin secreting pituitary carcinoma controlled long-term after temozolomide discontinuation.

Publication types

Case Reports

MeSH terms

Adult
Antineoplastic Agents / therapeutic use*
Carcinoma / complications
Carcinoma / drug therapy*
Carcinoma / genetics
Carcinoma / metabolism
Carcinoma / radiotherapy
Carcinoma / surgery
Combined Modality Therapy
Cranial Irradiation
Dacarbazine / analogs & derivatives*
Dacarbazine / therapeutic use
Dopamine Agonists / therapeutic use
Hormone Replacement Therapy
Humans
Hyperprolactinemia / drug therapy
Hyperprolactinemia / etiology
Hypophysectomy / adverse effects
Hypopituitarism / drug therapy
Hypopituitarism / etiology
Male
Multiple Endocrine Neoplasia Type 1 / drug therapy*
Mutation, Missense
Neoplasm Recurrence, Local / drug therapy*
Ophthalmoplegia / etiology
Pancreatic Neoplasms / diagnosis
Pancreatic Neoplasms / drug therapy
Pancreatic Neoplasms / genetics
Parathyroid Neoplasms / diagnosis
Parathyroid Neoplasms / drug therapy
Parathyroid Neoplasms / genetics
Pituitary Apoplexy / etiology
Pituitary Neoplasms / complications
Pituitary Neoplasms / drug therapy*
Pituitary Neoplasms / genetics
Pituitary Neoplasms / metabolism
Pituitary Neoplasms / radiotherapy
Pituitary Neoplasms / surgery
Prolactin / metabolism
Proto-Oncogene Proteins / genetics
Radiotherapy, Adjuvant
Remission Induction
Spinal Neoplasms / diagnosis
Spinal Neoplasms / drug therapy
Spinal Neoplasms / genetics
Temozolomide

Substances

Antineoplastic Agents
Dopamine Agonists
MEN1 protein, human
Proto-Oncogene Proteins
Dacarbazine
Prolactin
Temozolomide