Dimethyltriazenoimidazole carboxamide (DTIC) has now been reported to be effective in several tumors of neural crest origin. Besides its known efficacy against malignant melanoma, it has recently been reported to produce responses in two patients with the malignant carcinoid syndrome. Moreover, DTIC is included within the therapeutic armamentarium against childhood neuroblastoma. A 43-yr-old white man presented with classic clinical features of the malignant glucagonoma syndrome including hepatic metastases. Data from this presentation and the patient's diagnosis have been reported. A therapeutic trial of DTIC at doses of 250 mg/m2 daily for 5 consecutive days at monthly intervals was initiated. The patient has now completed 30 such courses with rather dramatic results. The cutaneous manifestations that had been among his most disabling symptoms began to improve steadily and completely resolved after six courses, with no subsequent recurrences. The patient's response to DTIC was excellent and prolonged (currently continuing 30 mth after the start of treatment). That there have now been two responses to DTIC coupled with few reports of other agents that have produced a positive therapeutic outcome suggests that DTIC should be an initial chemotherapeutic option in patients with metastatic glucagonoma.
ASJC Scopus subject areas
- Internal Medicine