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Low Immunohistochemical Expression of MGMT in ACTH Secreting Pituitary Tumors of Patients with Nelson Syndrome

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Abstract

MGMT expression in tumors has been correlated with response to treatment with temozolomide therapy. Few medical therapies are available for Nelson syndrome, and the efficacy of such therapeutics remains limited. The aim of the present study was to assess immunohistochemical expression of MGMT in ACTH-secreting pituitary adenomas of patients with Nelson syndrome. Our material consisted of eight specimens from ACTH-secreting pituitary adenomas of patients with Nelson syndrome. Immunohistochemical staining for MGMT was performed using the streptavidin-biotin-peroxidase complex method. MGMT immunoreactivity was assessed microscopically and recorded as an estimated percentage of nuclear MGMT immunostaining (0 = none, 1 = <10%, 2 = <25%, 3 = <50%, 4=>50%). Five of the eight specimens (65%) exhibited no MGMT immunoreactivity, with two out of eight cases (25%) showing slight MGMT staining (<10%) and one out of eight cases (12%) demonstrating moderate MGMT positivity (<25%). Patient male/female ratio was 3:5, with average patient age being 62.4 (range 57–66). Our findings suggest that temozolomide therapy may be of potential use in patients with Nelson syndrome, as these tumors express absent/low levels of MGMT. Absent or low MGMT staining in brain and other neoplasms has been shown to correlate with successful treatment with temozolomide, and recent reports of aggressive pituitary adenomas suggest similar outcomes.

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Acknowledgements

The authors thank the Jarislowsky Foundation and the Lloyd Carr-Harris Foundation for their generous support.

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Authors and Affiliations

  1. Department of Laboratory Medicine, St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada

    Fateme Salehi, Branavan Manoranjan, Soniya Sharma, Eva Horvath & Kalman Kovacs

  2. Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    Bernd W. Scheithauer

  3. Department of Endocrinology, St Bartholomew’s Hospital, London, UK

    Veronica J. Moyes & William M. Drake

  4. Department of Neurosurgery, Hospital Pablo Tobon Uribe, Medellin, Colombia

    Luis V. Syro

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  1. Fateme Salehi
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  2. Bernd W. Scheithauer
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  3. Veronica J. Moyes
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  4. William M. Drake
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  5. Luis V. Syro
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  6. Branavan Manoranjan
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  7. Soniya Sharma
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  8. Eva Horvath
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  9. Kalman Kovacs
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Correspondence to Bernd W. Scheithauer.

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Salehi, F., Scheithauer, B.W., Moyes, V.J. et al. Low Immunohistochemical Expression of MGMT in ACTH Secreting Pituitary Tumors of Patients with Nelson Syndrome. Endocr Pathol 21, 227–229 (2010). https://doi.org/10.1007/s12022-010-9138-3

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