ABSTRACT
Temozolomide is an alkylating agent used in the treatment of gliomas and, more recently, aggressive pituitary adenomas and carcinomas. Temozolomide methylates DNA and, thereby, has antitumor effects. O6-methylguanine-DNA methyltransferase, a DNA repair enzyme, removes the alkylating adducts that are induced by temozolomide, thereby counteracting its effects. A Medline search for all of the available publications regarding the use of temozolomide for the treatment of pituitary tumors was performed. To date, 46 cases of adenohypophysial tumors that were treated with temozolomide, including 30 adenomas and 16 carcinomas, have been reported. Eighteen of the 30 (60%) adenomas and 11 of the 16 (69%) carcinomas responded favorably to treatment. One patient with multiple endocrine neoplasia type 1 and an aggressive prolactin-producing adenoma was also treated and demonstrated a good response. No significant complications have been attributed to temozolomide therapy. Thus, temozolomide is an effective treatment for the majority of aggressive adenomas and carcinomas. Evidence indicates that there is an inverse correlation between levels of O6-methylguanine-DNA methyltransferase immunoexpression and therapeutic response. Alternatively, high-level O6-methylguanine-DNA methyltransferase immunoexpression correlates with an unfavorable response. Here, we review the use of temozolomide for treating pituitary neoplasms.
Subject(s)
Humans , Adenoma/drug therapy , Antineoplastic Agents, Alkylating/therapeutic use , Carcinoma/drug therapy , Dacarbazine/analogs & derivatives , Pituitary Neoplasms/drug therapy , Dacarbazine/therapeutic useABSTRACT
La plejopatía ya sea lumbosacra o braquial se refiere a la lesión de dos omás raíces en un mismo plejo. Este compromiso es muy frecuente en el paciente oncológico, e implica compresión generalmente extraespinal de dichas raíces por una neoplasia primaria o secundaria. La escanografía es muy útil en la evaluación de los pacientes que presentan esta entidad. En el presente artículo se revisan los aspectos anatómicos, los hallazgos clínicos más relevantes así como el enfoque del estudio escanográfico, elementos que permiten un diagnóstico de la enfermedad