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Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy.
World Neurosurg. 2011 Nov; 76(5):477.e16-20.WN

Abstract

OBJECTIVE

To report a series of four patients with uterine sarcoma, including one with müllerian adenosarcoma (MA) and three with low-grade endometrial stromal sarcoma (LGESS), who developed intracranial meningiomas while receiving the progesterone agonist megestrol acetate.

METHODS

The hospital records, imaging studies, and pathology slides of four patients who were treated for uterine sarcomas and subsequently developed intracranial meningiomas were reviewed.

RESULTS

All patients underwent surgery for their gynecologic cancers and received maintenance therapy with long-term hormonal suppression with megestrol acetate. Each of the four patients later developed neurologic symptoms secondary to intracranial meningiomas. Three patients had more than one meningioma. Histopathologic examination of all excised tumors showed strong immunoreactivity for progesterone receptors (PRs).

CONCLUSIONS

Patients with uterine sarcoma subtypes LGESS and MA may be predisposed to develop meningiomas, particularly in the setting of long-term treatment with megestrol acetate. Alternatively, preexisting, clinically silent meningiomas in these patients may have progressed to the point of clinical symptoms in the presence of the progesterone agonist megestrol acetate. Without previous imaging studies showing the presence or absence of meningioma before initiation of megestrol acetate treatment, there is no way to draw definitive conclusions regarding this possibility. Clinical and neuroradiologic surveillance for meningiomas should be strongly considered in patients with these uterine sarcoma subtypes, particularly in patients undergoing long-term suppressive therapy with megestrol acetate.

Authors+Show Affiliations

Department of Neurosurgery, Roswell Park Cancer Institute and School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA. tjgruber@buffalo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22152580

Citation

Gruber, Thomas J., et al. "Intracranial Meningiomas in Patients With Uterine Sarcoma Treated With Long-term Megestrol Acetate Therapy." World Neurosurgery, vol. 76, no. 5, 2011, pp. 477.e16-20.
Gruber TJ, Fabiano AJ, Deeb G, et al. Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy. World Neurosurg. 2011;76(5):477.e16-20.
Gruber, T. J., Fabiano, A. J., Deeb, G., Lele, S. B., & Fenstermaker, R. A. (2011). Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy. World Neurosurgery, 76(5), e16-20. https://doi.org/10.1016/j.wneu.2011.03.035
Gruber TJ, et al. Intracranial Meningiomas in Patients With Uterine Sarcoma Treated With Long-term Megestrol Acetate Therapy. World Neurosurg. 2011;76(5):477.e16-20. PubMed PMID: 22152580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy. AU - Gruber,Thomas J, AU - Fabiano,Andrew J, AU - Deeb,George, AU - Lele,Shashikant B, AU - Fenstermaker,Robert A, PY - 2010/11/15/received PY - 2011/03/03/revised PY - 2011/03/25/accepted PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/2/10/medline SP - 477.e16 EP - 20 JF - World neurosurgery JO - World Neurosurg VL - 76 IS - 5 N2 - OBJECTIVE: To report a series of four patients with uterine sarcoma, including one with müllerian adenosarcoma (MA) and three with low-grade endometrial stromal sarcoma (LGESS), who developed intracranial meningiomas while receiving the progesterone agonist megestrol acetate. METHODS: The hospital records, imaging studies, and pathology slides of four patients who were treated for uterine sarcomas and subsequently developed intracranial meningiomas were reviewed. RESULTS: All patients underwent surgery for their gynecologic cancers and received maintenance therapy with long-term hormonal suppression with megestrol acetate. Each of the four patients later developed neurologic symptoms secondary to intracranial meningiomas. Three patients had more than one meningioma. Histopathologic examination of all excised tumors showed strong immunoreactivity for progesterone receptors (PRs). CONCLUSIONS: Patients with uterine sarcoma subtypes LGESS and MA may be predisposed to develop meningiomas, particularly in the setting of long-term treatment with megestrol acetate. Alternatively, preexisting, clinically silent meningiomas in these patients may have progressed to the point of clinical symptoms in the presence of the progesterone agonist megestrol acetate. Without previous imaging studies showing the presence or absence of meningioma before initiation of megestrol acetate treatment, there is no way to draw definitive conclusions regarding this possibility. Clinical and neuroradiologic surveillance for meningiomas should be strongly considered in patients with these uterine sarcoma subtypes, particularly in patients undergoing long-term suppressive therapy with megestrol acetate. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/22152580/Intracranial_meningiomas_in_patients_with_uterine_sarcoma_treated_with_long_term_megestrol_acetate_therapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(11)00367-6 DB - PRIME DP - Unbound Medicine ER -