Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma

Sujit S. Prabhu, Kenneth D. Aldape, Robert F. Gagel, Robert S. Benjamin, Jonathan Trent, Ian E. McCutcheon

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Although the benefits of radiotherapy for pituitary adenomas are well-documented, post-irradiation sarcomas of the sella are rarely seen, with only 20 cases (mainly of fibrosarcoma) reported in the medical literature. Method: We describe a case of post-irradiation sarcoma five years after surgery followed by external-beam irradiation for an extensive and locally invasive growth hormone-secreting tumor. The patient was subsequently given pegvisomant, an antagonist of growth hormone receptor, to control symptoms of growth hormone excess. Results: The patient underwent transsphenoidal resection of the recurrent tumor, followed by adjuvant chemotherapy. This led to significant relief in the patient's symptoms including radiological evidence of tumor shrinkage, but the tumor regrew when, owing to dose-limiting toxicity, chemotherapy was stopped. Conclusions: Post-irradiation sarcomas of the pituitary are well-recognized but rare. They should be suspected in patients following sellar irradiation who show abrupt onset of new symptoms and appropriate radiological findings, and such tumors may respond to cytotoxic chemotherapy.

Original languageEnglish
Pages (from-to)378-383
Number of pages6
JournalCanadian Journal of Neurological Sciences
Volume30
Issue number4
StatePublished - Nov 1 2003
Externally publishedYes

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Growth Hormone-Secreting Pituitary Adenoma
Sarcoma
Neoplasms
Pituitary Irradiation
Somatotropin Receptors
Drug Therapy
Fibrosarcoma
Pituitary Neoplasms
Adjuvant Chemotherapy
Growth Hormone
Radiotherapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Prabhu, S. S., Aldape, K. D., Gagel, R. F., Benjamin, R. S., Trent, J., & McCutcheon, I. E. (2003). Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma. Canadian Journal of Neurological Sciences, 30(4), 378-383.

Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma. / Prabhu, Sujit S.; Aldape, Kenneth D.; Gagel, Robert F.; Benjamin, Robert S.; Trent, Jonathan; McCutcheon, Ian E.

In: Canadian Journal of Neurological Sciences, Vol. 30, No. 4, 01.11.2003, p. 378-383.

Research output: Contribution to journalArticle

Prabhu, SS, Aldape, KD, Gagel, RF, Benjamin, RS, Trent, J & McCutcheon, IE 2003, 'Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma', Canadian Journal of Neurological Sciences, vol. 30, no. 4, pp. 378-383.
Prabhu SS, Aldape KD, Gagel RF, Benjamin RS, Trent J, McCutcheon IE. Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma. Canadian Journal of Neurological Sciences. 2003 Nov 1;30(4):378-383.
Prabhu, Sujit S. ; Aldape, Kenneth D. ; Gagel, Robert F. ; Benjamin, Robert S. ; Trent, Jonathan ; McCutcheon, Ian E. / Sarcomatous Change after Sellar Irradiation in a Growth Hormone-Secreting Pituitary Adenoma. In: Canadian Journal of Neurological Sciences. 2003 ; Vol. 30, No. 4. pp. 378-383.
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