Symptomatic progestin-associated atypical grade II meningioma. A first case report

Roux, Alexandre; Tauziède‐Espariat, Arnault; Zanello, Marc; Gareton, Albane; Malaizé, Henri; Benzakoun, Joseph; Zah‐Bi, Gilles; Oppenheim, Catherine; Plu‐Bureau, Geneviève; Chrétien, Fabrice; Pallud, Johan

doi:10.1016/j.neuchi.2019.12.013

Cited by 12 publications

(6 citation statements)

References 24 publications

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“…NOMAC shares several biological effects with CPA as an anti-androgenic and progestative agonist. In addition, authors are currently interested in another progesterone analogue, CMA and its potential association with meningiomas [36,37].…”

Section: Discussionmentioning

confidence: 99%

Meningiomas and cyproterone acetate: a retrospective, monocentric cohort of 388 patients treated by surgery or radiotherapy for intracranial meningioma

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Meningiomas and cyproterone acetate: a retrospective, monocentric cohort of 388 patients treated by surgery or radiotherapy for intracranial meningioma

et al. 2021

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“…Recently, a link was found between CMA and the development of a benign brain tumor, meningioma. However, it has been described only for long‐term treatment, and the resulting recommendation is to have a pretreatment and follow‐up MRI scan at 5 years or if symptomatic 22 . In the present protocol, patients were treated with CMA for 6 months, so the risk of meningioma seems minimal.…”

Section: Discussionmentioning

confidence: 99%

Prospective study of fertility‐sparing treatment with chlormadinone acetate for endometrial carcinoma and atypical hyperplasia in young women

Ouasti

Bucau

Larouzee

et al. 2021

Intl J Gynecology & Obste

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Objective To confirm that the efficiency of the use of chlormadinone acetate for 6 months to obtain remission of atypical hyperplasia or endometrial carcinoma is comparable to that of the use of other fertility‐sparing treatments. Method The present study is based on the PREFERE prospective registry. All the patients received 3 or 6 months of chlormadinone acetate and were evaluated by hysteroscopic resection and pipelle sampling every 3 months. Results Ninety‐four patients were included. Seventy‐nine patients achieved complete remission at 6 months (84%). No patients stopped treatment because of a lack of tolerance. Twenty‐four per cent of the patients achieved a live birth. Conclusion Chlormadinone acetate is an effective and well‐tolerated fertility‐sparing treatment. Its benefits over other progestins are its tolerability, and its absence of contraindications, which make it a good choice for patients with thromboembolism and high vascular risk.

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“…Based on recent publications [1-14, 19-27, 36, 37], surgical treatment of meningiomas should be proposed with caution in case of CA exposure because of potential meningioma regression after progestin withdrawal. For patients with NA [8,13,[24][25][26] and ChlA [13,15,25,27] exposure, the potential tumor regression appears less signi cant in the literature. The potential impact of NA and ChlA on meningioma growth is probably different from CA on a biomolecular point of view.…”

Section: High Grade Meningioma Identi Cationmentioning

confidence: 99%

“…Several reports have documented an increased risk of meningioma development in patients with long term progestative treatment but causal relationship remains di cult to prove. Similarly, some authors reported a relationship between long term nomegestrol acetate (NA) [8,13,[24][25][26] or chlormadinone acetate (ChlA) [13,15,25,27] treatment and meningioma development. Meningioma regression after CA withdrawal is reported by many authors [2-5, 7-10, 12-15, 19, 21-24, 26, 28] in one third of cases especially for anterior and middle skull base locations.…”

Section: Introductionmentioning

confidence: 98%

“…Despite recent publications [9, 13, 15, 17-19, 22, 27] in which high grade hormonal induced meningiomas were found, no study concerning their speci c long-term outcome is reported. Concerning sporadic meningiomas, recent studies reported a 15-20% rate of high grade meningioma [13,27,[29][30][31][32][33]. The progression-free survival rate (PFSR) of patients harboring a sporadic grade II meningioma is approximately 50% at 5 years questioning in these cases the indication for adjuvant radiation therapy [29][30][31][33][34][35].…”

Section: Introductionmentioning

confidence: 99%

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Have Progestin Related and Sporadic High Grade Meningiomas the Same Natural History?

Devalckeneer¹,

Aboukaïs²,

Faisant³

et al. 2021

Preprint

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Introduction: High grade progestin related meningiomas have been reported in recent series but we found no previous study describing their long-term outcome. Our study aimed to evaluate patients operated on for high grade intracranial meningioma and who underwent long term exposure to high dose of cyproterone acetate, nomegestrol acetate and chlormadinone acetate.Methods: Our study retrospectively included 9 patients with high grade progestin related intracranial meningioma between December 2006 and December 2020. In each patient, clinico-radiological follow-up was performed every 6 months after diagnosis and treatment withdrawal recommendation. Results: The mean progestative exposure was 11.4 years. Edema existence or absence of cleft sign on MRI were the key factors for surgical indication. All patients underwent surgery. Ajduvant radiotherapy was indicated in 1 patient, and Gamma Knife Radiosurgery was proposed in 2 other patients for a second location of mengioma. 6 patients harbored a grade II chordoïd meningioma subtype with 100% PR expression and 3 patients a grade II atypical meningioma subtype with lower PR expression. The mean follow-up was 7.1 years and none of the 9 patients presented with a recurrence.Conclusion: Patients with Grade II progestin related meningiomas have less tumor recurrence after surgery than patients with sporadic high grade meningomas, especially after progestin withdrawal. The presence/ appearance of peri-meningioma edema and the absence of cleft sign before volumetric change should suggest the existence of an underlying high grade meningioma. In these cases, surgical resection may immediately be considered and adjuvant radiotherapy should be reserved for proven recurrence cases.

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Symptomatic progestin-associated atypical grade II meningioma. A first case report

Cited by 12 publications

References 24 publications

Meningiomas and cyproterone acetate: a retrospective, monocentric cohort of 388 patients treated by surgery or radiotherapy for intracranial meningioma

Meningiomas and cyproterone acetate: a retrospective, monocentric cohort of 388 patients treated by surgery or radiotherapy for intracranial meningioma

Prospective study of fertility‐sparing treatment with chlormadinone acetate for endometrial carcinoma and atypical hyperplasia in young women

Have Progestin Related and Sporadic High Grade Meningiomas the Same Natural History?

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