Acute Progression of Recurrent Meningioma during Luteinizing Hormone-Releasing Hormone Agonist Treatment for Prostate Cancer

World Neurosurg. 2016 Jul:91:670.e1-6. doi: 10.1016/j.wneu.2016.03.076. Epub 2016 Mar 30.

Abstract

Background: Meningiomas are the most common type of benign brain tumor, and the incidence of meningioma in women is more than twofold higher than in men. Several studies have demonstrated that hormones are somehow related to the growth of meningiomas.

Case description: A 72-year-old man with benign meningioma underwent tumor resection and had no recurrence for 18 years. He was found to have prostate cancer, and he received hormonal therapy with a luteinizing hormone-releasing hormone (LHRH) agonist. Two years later, he developed severe cognitive dysfunction and gait disturbance. Gadolinium-enhanced brain magnetic resonance imaging revealed a large recurrent mass and obstructive hydrocephalus. Staged resection was performed and stereotactic radiation therapy was administered against the residual tumor. His symptoms improved after endoscopic third ventriculostomy for obstructive hydrocephalus and his residual tumor remains stable.

Conclusions: This is the first report of a case in which an LHRH agonist promoted the growth of a pre-existing meningioma. We suggest that patients with a history of meningioma who are receiving LHRH agonist treatment should be closely monitored.

Keywords: LHRH agonist; Meningioma; Prostate cancer; Recurrence.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Hormonal / therapeutic use*
  • Cognition Disorders / etiology
  • Disease Progression
  • Gadolinium / pharmacokinetics
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Ki-67 Antigen / metabolism
  • Leuprolide / therapeutic use*
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / diagnostic imaging
  • Meningeal Neoplasms / drug therapy*
  • Meningeal Neoplasms / surgery
  • Meningioma / drug therapy
  • Meningioma / surgery
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm, Residual / surgery
  • Prostatic Neoplasms / complications
  • Prostatic Neoplasms / drug therapy*
  • Radiosurgery

Substances

  • Antineoplastic Agents, Hormonal
  • Ki-67 Antigen
  • Gadolinium
  • Leuprolide