Temozolomide-Induced Shrinkage of Invasive Pituitary Adenoma in Patient with Nelson’s Syndrome: A Case Report and Review of the Literature
Table 2
The process of TMZ treatment of corticotroph pituitary adenoma in Nelson’s syndrome in our patient.
Stage of treatment with TMZ
Clinical symptoms
ACTH (pg/mL) normal range 7.2–63.3
MRI, volume (mL) of the tumor
Before treatment
Recurrent headaches and blindness of the right eye due to optic chiasm compression
23830
16.137
After the first cycle
Return of light sensitivity in right eye
12110
—
After three cycles
Further conspicuous improvement of vision in right eye. Improvement of general appearance and feeling and reduction of hypotension drugs and daily insulin doses
9215
12.935 Reduction in tumor volume of 19.8% (3.202 mL)
After six cycles
Further improvement of vision in right eye and general condition of the patient
5712
11.725 Further reduction in tumor volume of 9.3% (1.21 mL)