Sustained growth of intraosseous hormone-associated meningiomas after cessation of progestin therapy

Acta Neurochir (Wien). 2021 Jun;163(6):1705-1710. doi: 10.1007/s00701-021-04781-8. Epub 2021 Mar 2.

Abstract

Hormone-associated meningiomas tend to stop growing or decrease in size after cessation of certain progestins, mainly cyproterone acetate. We report three observations on the natural history of hormone-associated intraosseous meningiomas, showing in a first patient that those tumors may grow rapidly under nomegestrol. We then demonstrate the sustained growth of intraosseous hormone-associated meningiomas after cessation of promesgestone and nomegestrol, independently of the intracranial portion, which concurrently decreased in size in the second case or was resected at the time of nomegestrol withdrawal in the third case, thus giving new insights into the tumorigenesis mechanisms of hormone-associated intraosseous meningiomas.

Keywords: Meningioma; Natural history; Nomegestrol acetate; Primary brain tumor; Progestin; Wait-and-scan strategy.

Publication types

  • Case Reports

MeSH terms

  • Cell Proliferation / drug effects
  • Cyproterone Acetate / therapeutic use
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Megestrol / analogs & derivatives
  • Megestrol / therapeutic use
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / drug therapy*
  • Meningeal Neoplasms / pathology*
  • Meningioma / diagnostic imaging
  • Meningioma / drug therapy*
  • Meningioma / pathology*
  • Middle Aged
  • Progestins / therapeutic use*

Substances

  • Progestins
  • nomegestrol
  • Cyproterone Acetate
  • Megestrol