Meningioma growth during interferon beta-1a treatment for multiple sclerosis

Abstract

Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS) with a long-term course in the majority of patients. As all chronic illnesses, it is possible to expect the concomitant occurrence of other diseases, like CNS tumors 1,2 . Some studies have been described CNS tumors in MS patients and we were able to find 31 cases reported, including 6 meningiomas, in English literature [1][2][3] . Meningioma is rarely described in MS patients, particularly during treatment with Interferon beta (INFb).We report meningioma growth in our MS patient during INFb-1a treatment, depicted by brain MRI scans. Immunohistochemistry results are also confronted with those earlier reported. caseA 51 year-old woman was diagnosed as having possible MS in 1992 due to numbness and weakness in her left lower limb. Fundoscopy and the remaining neurological examination were unremarkable at that time. In 1996, she had a second bout and was submitted to her first MRI that did not show evidence of the tumor. Cerebrospinal fluid (CSF) examination revealed oligoclonal bands and a diagnosis of definite MS was established. Serial MRI scans demonstrated several small demyelinating foci in the spi Fig 1. (A,

Secondary Progression is Not the Only Explanation

“…However, the role of these receptors is surrounded by controversy in this context, because an inhibitory effect in meningioma cells was showed in vitro using interferon alpha. 12 Gama et al 13 have described another case of an intracranial meningioma in a patient with MS treated with interferon beta-1a. They also speculated about the possible role of the drug on the tumour growth rate, which was not different from what is actually expected for meningiomas (normal range: 0.24-1.0 cm/year).…”

Meningioma after immunomodulation for multiple sclerosis

“…There is some controversy in the literature about the incidence of brain tumors in MS patients [1][2][3] . Our patient used interferon beta-1a for seven years, when the immunomodulatory treatment was switched to glatiramer acetate.…”

“…Meningiomas have been rarely seen in MS patients and their occurrence has been observed during the course of immunomodulatory drugs such as interferon beta1a and beta-1b [1][2][3] . We report a case of a frontal meningioma in a patient with relapsing-remitting multiple sclerosis (RRMS) treated with interferon beta-1a for seven years followed by glatiramer acetate for three years.…”