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Pituitary

, Volume 13, Issue 4, pp 367–379 | Cite as

MGMT immunoexpression in aggressive pituitary adenoma and carcinoma

  • Queenie Lau
  • Bernd Scheithauer
  • Kalman Kovacs
  • Eva Horvath
  • Luis V. Syro
  • Ricardo Lloyd
Article

Abstract

Recent case reports have documented the efficacy of temozolomide therapy in some aggressive pituitary adenomas and pituitary carcinomas resistant to multimodality therapy. Evidence suggests that low O6-methylguanine-DNA methyltransferase (MGMT) immunoexpression correlates with response to temozolomide chemotherapy. Herein, we aimed to study MGMT immunoexpression in a spectrum of pituitary tumors, indolent, aggressive and malignant. A literature review of the use of temozolomide in pituitary tumors was also performed. Immunohistochemistry for MGMT was performed on 60 pituitary tumors identified in the Mayo Clinic Tissue Registry and the consultation files of one of us (BWS). The group included 30 pituitary carcinomas (15 ACTH, 10 PRL, 1 FSH/LH, 1 TSH, 1 silent subtype 3 and 2 null cell). Tissue from recurrences was available in 17 cases. In addition, 30 functionally different pituitary adenomas were studied, including 15 invasive and 15 non-invasive adenomas. Overall, 32 cases of pituitary tumors (54%) demonstrated low MGMT immunoexpression. This included 17 of 30 (57%) carcinomas, 9 of 15 (60%) invasive adenomas, and 6 of 15 cases (40%) of non-invasive pituitary adenomas. There was no significant change in MGMT immunoexpression between primary and recurrent tumors. Prolactin-producing carcinomas had the highest proportion of tumors (80%) with low expression. A significant proportion of pituitary adenomas and carcinomas demonstrate low MGMT immunoexpression. In an effort to anticipate the likelihood of a temozolomide response, all cases of aggressive pituitary tumors should be assessed for MGMT expression.

Keywords

Pituitary carcinoma Pituitary adenoma Temozolomide MGMT Treatment 

Notes

Acknowledgments

The authors would like to thank Mrs. Michelle Lemke and Mrs. Denise Chase of Mayo Clinic for their research assistance and secretarial support, respectively.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Queenie Lau
    • 1
    • 2
  • Bernd Scheithauer
    • 2
  • Kalman Kovacs
    • 3
  • Eva Horvath
    • 3
  • Luis V. Syro
    • 4
  • Ricardo Lloyd
    • 2
  1. 1.Department of Anatomical Pathology and CytopathologyRoyal Brisbane and Women’s Hospital and Gold Coast HospitalQueenslandAustralia
  2. 2.Department of Laboratory Medicine and PathologyMayo ClinicRochesterUSA
  3. 3.Department of Laboratory MedicineSt. Michael’s HospitalTorontoCanada
  4. 4.Department of NeurosurgeryHospital Pablo Tobon Uribe and Clinica MedellinMedellinColombia

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