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Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients.
Acta Neurochir (Wien). 2015 Oct; 157(10):1741-6.AN

Abstract

BACKGROUND

The relationship between meningiomas and exogenous sex hormones is well known, but cyproterone acetate (CA), a progesterone agonist, seems to have a stronger influence on tumor growth.

OBJECTIVE

To show the close relationship between CA treatment and meningioma growth.

METHODS

Since 2010, all patients referred to our clinic for a suspicion of meningioma were questioned specifically about exogenous sex hormone intake and more specifically about CA intake. Twelve patients harboring one or multiple meningiomas and treated with CA were identified. CA was stopped in all cases. Tumor volumes and diameters were measured on serial MRIs and compared to the last MRI before CA withdrawal.

RESULTS

Ten patients with multiple tumors had been taking the drug for a longer period of time (mean of 20.4 years) than the two patients with one tumor (10 years). Two patients with multiple tumors underwent surgery because of rapidly decreased visual acuity at the time of diagnosis. Discontinuation of CA led to tumor shrinkage in 11 patients and a stop in tumor growth in one [mean tumor volume reduction was around 10 cm(3)/year; range (0.00; 76)]. There was no regrowth during a mean follow-up period of 12 months (range: 5-35).

CONCLUSION

For patients diagnosed with a meningioma and treated with CA, medication withdrawal followed by observation should be the first line of treatment. Care should be taken with long-term use of high doses of CA, and serial brain MRIs should be considered after several years of CA.

Authors+Show Affiliations

Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France. annelaure.bernat@lrb.aphp.fr.Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France.Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France.Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France. Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France.Department of Gynecology, Hôpital Lariboisière, Paris, France.Department of Visceral Surgery, Hôpital Lariboisière, Paris, France.Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France.Department of Neurosurgery, Hôpital Lariboisière, Paris VII-Diderot University, 2 rue Ambroise Pare, Paris, 75475, France.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26264069

Citation

Bernat, Anne Laure, et al. "Growth Stabilization and Regression of Meningiomas After Discontinuation of Cyproterone Acetate: a Case Series of 12 Patients." Acta Neurochirurgica, vol. 157, no. 10, 2015, pp. 1741-6.
Bernat AL, Oyama K, Hamdi S, et al. Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients. Acta Neurochir (Wien). 2015;157(10):1741-6.
Bernat, A. L., Oyama, K., Hamdi, S., Mandonnet, E., Vexiau, D., Pocard, M., George, B., & Froelich, S. (2015). Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients. Acta Neurochirurgica, 157(10), 1741-6. https://doi.org/10.1007/s00701-015-2532-3
Bernat AL, et al. Growth Stabilization and Regression of Meningiomas After Discontinuation of Cyproterone Acetate: a Case Series of 12 Patients. Acta Neurochir (Wien). 2015;157(10):1741-6. PubMed PMID: 26264069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients. AU - Bernat,Anne Laure, AU - Oyama,Kenichi, AU - Hamdi,Selma, AU - Mandonnet,Emmanuel, AU - Vexiau,Dominique, AU - Pocard,Marc, AU - George,Bernard, AU - Froelich,Sebastien, Y1 - 2015/08/12/ PY - 2015/05/07/received PY - 2015/07/30/accepted PY - 2015/8/13/entrez PY - 2015/8/13/pubmed PY - 2016/4/22/medline KW - Cyproterone acetate KW - Meningioma KW - Meningiomatosis KW - Progesterone agonist SP - 1741 EP - 6 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 157 IS - 10 N2 - BACKGROUND: The relationship between meningiomas and exogenous sex hormones is well known, but cyproterone acetate (CA), a progesterone agonist, seems to have a stronger influence on tumor growth. OBJECTIVE: To show the close relationship between CA treatment and meningioma growth. METHODS: Since 2010, all patients referred to our clinic for a suspicion of meningioma were questioned specifically about exogenous sex hormone intake and more specifically about CA intake. Twelve patients harboring one or multiple meningiomas and treated with CA were identified. CA was stopped in all cases. Tumor volumes and diameters were measured on serial MRIs and compared to the last MRI before CA withdrawal. RESULTS: Ten patients with multiple tumors had been taking the drug for a longer period of time (mean of 20.4 years) than the two patients with one tumor (10 years). Two patients with multiple tumors underwent surgery because of rapidly decreased visual acuity at the time of diagnosis. Discontinuation of CA led to tumor shrinkage in 11 patients and a stop in tumor growth in one [mean tumor volume reduction was around 10 cm(3)/year; range (0.00; 76)]. There was no regrowth during a mean follow-up period of 12 months (range: 5-35). CONCLUSION: For patients diagnosed with a meningioma and treated with CA, medication withdrawal followed by observation should be the first line of treatment. Care should be taken with long-term use of high doses of CA, and serial brain MRIs should be considered after several years of CA. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/26264069/Growth_stabilization_and_regression_of_meningiomas_after_discontinuation_of_cyproterone_acetate:_a_case_series_of_12_patients_ L2 - https://dx.doi.org/10.1007/s00701-015-2532-3 DB - PRIME DP - Unbound Medicine ER -