Hormonal therapies and meningioma: Is there a link?

Soriano, Lucía Cea; Blenk, Tilo; Wallander, Mari‐Ann; Rodrı́guez, Luis A. Garcı́a

doi:10.1016/j.canep.2011.08.003

Cited by 74 publications

(69 citation statements)

References 54 publications

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“…Two publications by Andersen et al 7,8 are included as one study because the data came from the same source, the Danish National Registries, at the same time. A study by Cea-Soriano et al 19 which included 745 cases of meningioma was not eligible because it used data from the THIN UK primary care database, which overlaps with the GPRD. A study by Blitshteyn et al was not eligible because not all information on HT use was prospectively collected.…”

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

“…A study by Blitshteyn et al was not eligible because not all information on HT use was prospectively collected. 118 (27) 535 (30) 90 (33) 318 (29) Missing 598 (17) 2,723 (19) 126 (18) 504 (18) 150 (13) 776 (16) 59 (13) 332 (19) 49 (18) 216 (20) Alcohol,…”

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

“…2,316 (17) 111 (16) 443 (16) 224 (19) 825 (17) 76 (17) 272 (15) 51 (19) 166 ( (24) 158 (23) 644 (23) 222 (19) 1,002 (21) 81 (18) 417 (24) 67 (25) 274 ( (48) 195 (44) 826 (47) 153 (56) 529 (49) Missing 664 (19) 2,932 (21) 134 (19) 537 (19) 180 (15) 859 (18) 68 (15) 361 (21) 53 (19) 229 (21) Height cm, 2,932 (21) 134 (19) 537 (19) 180 (15) 859 (18) 68 (15) 361 (21) 53 (19) 229 (21) 1 Controls matched to cases on age at index date, general practice and observation period in GPRD (see Methods). The difference between the risk of glioma and of meningioma was not significant in users of estrogen-only HT or in users of estrogen-progestin HT.…”

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

See 2 more Smart Citations

Menopausal hormone therapy and central nervous system tumor risk: Large UK prospective study and meta‐analysis

Benson

Kirichek

Beral³

et al. 2014

Intl Journal of Cancer

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Female sex hormones are thought to affect women's risk of developing central nervous system (CNS) tumors. Some have reported an increased risk in users of menopausal hormone therapy (HT) but evidence is limited. In the UK General Practice Research Database we compared prospectively collected information on HT prescriptions in women aged 50-79 years with CNS tumors diagnosed in 1987-2011 with that in matched controls (four per case). Relative risks (RRs) in relation to prescribed HT were calculated overall and by CNS tumor subtype. Statistical tests are two-sided. For all CNS tumors (n 5 3,500), glioma (n 5 689), meningioma (n 5 1,197), acoustic neuroma (n 5 439), and pituitary tumors (n 5 273) adjusted RRs for women prescribed HT versus not were, respectively, 1.21 (95% confidence intervals (CI) 5 1.10-1.32, p < 0.0001), 1.14 (0.93-1.40, p 5 0.2), 1.30 (1.11-1.51, p 5 0.001), 1.37 (1.06-1.75, p 5 0.01), and 1.35 (0.99-1.85, p 5 0.06). There was no significant difference in risk by tumor subtype (p heterogeneity 5 0.6). A meta-analysis was conducted, combining our results with those from other published studies with prospectively collected exposure information. The meta-analyses yielded significantly increased risks for all CNS tumors, glioma and meningioma in users of estrogen-only [1.35 (1.22-1.49), 1.23 (1.06-1.42) and 1.31 (1.20-1.43), respectively] but not estrogen-progestin HT [1.09 (0.99-1.19), 0.92 (0.78-1.08) and 1.05 (0.95-1.16), respectively]; these differences were statistically significant (p < 0.005 for each tumor type). There was no significant difference between glioma and meningioma risk in users of estrogen-only HT. The totality of the available evidence suggests an increased risk of all CNS tumors (and of glioma and meningioma separately) in users of estrogen-only HT. Absolute excess risk (2 per 10,000 users over 5 years) is small.Use of some types of hormone therapy (HT) for the menopause has been associated with an increased risk of cancers of the breast, ovary, and endometrium and decreased risk of cancers of the gastrointestinal tract.1,2 Some, but not all, have reported an increase in the risk of certain central nervous system (CNS) tumors in HT users. [3][4][5][6][7][8][9][10][11][12][13] Evidence is limited by the lack of systematic reporting of findings for all CNS tumors combined, as well as by different tumor subtypes and by specific HT preparations. The findings for all CNS tumors combined are of public health relevance. Reliable assessment of the association between HT use and CNS tumors requires careful control of potential sources of appreciable bias, such as from selective participation or recall of HT use within studies. Differential reporting of HT use in studies where information was recorded retrospectively, i.e., after women had been diagnosed with CNS tumors, is an important source of such bias.To study the association between use of different types of HT and the risk of CNS tumors we used prospectively recorded prescribing information for HT in a case-control study nested ...

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Section: Systematic Review and Meta-analysismentioning

confidence: 99%

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

Section: Systematic Review and Meta-analysismentioning

confidence: 99%

See 1 more Smart Citation

Menopausal hormone therapy and central nervous system tumor risk: Large UK prospective study and meta‐analysis

Benson

Kirichek

Beral³

et al. 2014

Intl Journal of Cancer

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“…Recent studies exploring relationship between meningiomas and hormones have focused on the role of antiandrogens. Increased risk of meningioma in patients on high-dose cyproterone acetate with exposures longer than 1 year was confirmed in a Spanish prospective cohort study [9]. In a similar study, association between high-dose cyproterone acetate and increased risk of meningioma was only seen in male users on high-dose, short-term therapy [10].…”

Section: Environmental Risk Factors For Meningioma Growthmentioning

confidence: 82%

New insights into meningioma

Vranic

Peyre²,

Kalamaridès³

2012

Current Opinion in Oncology

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“…They did not detect a significantly increased risk of meningioma among female users of low-doses of cyproterone acetate (50 mg or less a day), when compared with non-users, whereas said risk was significantly higher among male users of high-dose cyproterone acetate (more than 50 mg daily) when compared with non-users. 9 Gil et al in 2011 published the results of a retrospective cohort study performed using Spanish primary care database. They compared incidence rates of meningiomas in patients exposed to high-dose (50 mg or more a day) and low doses (50 mg or less daily) of cyproterone acetate (considered users) with those in non-exposed patients.…”

Section: Discussionmentioning

confidence: 98%

Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexual

Bergoglio

Gómez-Balaguer

Folch

et al. 2013

Endocrinología y Nutrición (English Edition)

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Transsexualism is defined as a strong conviction of belonging to the opposite sex in individuals without any physical intersex condition. Cross-sex hormone therapy is an important component of medical treatment of transexuals but it is not exempt from adverse effects.We report a case of a meningioma in a male-to-female transsexual patient treated with estrogens and cyproterone acetate for the past 4 years. He claimed recently severe headache and visual impairment. Blood tests showed normal results. A contrast-enhanced magnetic resonance imaging (MRI) scan revealed a mass in the tuberculum sellae consistent with a meningioma. Treatment was discontinued and tumor resection was performed. Histologic diagnosis confirmed strongly progesterone receptor-positive and estrogen negative meningioma. After surgery, the patient rejected the possibility of continuing with the treatment of estrogens and cyproterone, and so triptorelin (GnRH agonist) was initiated. At 1-year follow-up the patient's symptoms had ameliorated and a MRI scan revealed no recurrence of the tumor. This is the third case reported in the literature of a meningioma after treatment with estrogens and cyproterone acetate. We consider extremely important a long-term follow-up observation of male-to-female transsexual undergoing cross-sex hormone therapy in order to detect as soon as possible the adverse effects that can be derived from this therapy.Terapia hormonal cruzada; Acetato de ciproterona; Meningioma; Estrógenos; Meningioma sintomático inducido por tratamiento hormonal cruzado en un transexual hombre a mujerResumen El transexualismo se define como una fuerte convicción de pertenecer al sexo opuesto en aquellos individuos que no tienen ninguna patología intersexual. La terapia hormonal cruzada es un componente fundamental del tratamiento médico de los transexuales, pero debemos tener en cuenta que no está exenta de efectos adversos.Comunicamos un caso de meningioma en un transexual de hombre-mujer tratado con estrógenos y acetato de ciproterona durante 4 años, que consulta por cefalea y alteraciones (M.T. Bergoglio).Meningioma in male-to-female transsexual 265 Transexual hombre-mujer; Efectos adversos visuales. Los análisis de sangre eran normales y en la resonancia magnética (RM) se describía una masa en el tubérculo sellar compatible con meningioma. Con estos resultados se interrumpió el tratamiento y se remitió al paciente a cirugía para resección del tumor. La histología tumoral confirmó un meningioma con receptores de progesterona muy positivos y receptores de estrógenos negativos. Tras la cirugía, el paciente desestimó continuar con el tratamiento hormonal cruzado por lo que se comenzó tratamiento con triptorelina (análogo de GnRH). Al año de seguimiento los síntomas habían mejorado significativamente y en la RM de control no había signos de recidiva tumoral.Este es el tercer caso publicado en la literatura de un meningioma tras tratamiento con estrógenos y progesterona. Consideramos muy importante el seguimiento a largo plazo de los pacientes t...

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Hormonal therapies and meningioma: Is there a link?

Cited by 74 publications

References 54 publications

Menopausal hormone therapy and central nervous system tumor risk: Large UK prospective study and meta‐analysis

Menopausal hormone therapy and central nervous system tumor risk: Large UK prospective study and meta‐analysis

New insights into meningioma

Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexual

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