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Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients.
Acta Neurochir (Wien) 2019; 161(4):761-765AN

Abstract

BACKGROUND

The relationship between increased meningioma incidence and growth and long-term hormonal therapy with cyproterone acetate (CPA) in women has been recently established in literature. Following the raise in awareness from hormonal treatment, we describe a potential relationship between the progesterone agonist nomegestrol acetate (NOMAC) and meningioma growth.

METHODS

After implementation of a screening protocol to detect potential interactions between hormonal exposure and occurrence of meningioma, we identified patients taking NOMAC and newly diagnosed with a meningioma. NOMAC was stopped and those patients were followed tightly both clinically and radiologically. Retrospective volumetric analysis of the tumors was performed on the imaging.

RESULTS

Three patients were identified for the study. After cessation of the NOMAC, tumor shrinkage was documented for all meningiomas within the first month. Up to 70% of tumor volume reduction was observed during the first year of follow-up in one of them. None of the patients developed new symptoms.

CONCLUSION

We report the first cases of meningiomas responsiveness to discontinuation of hormonal therapy with NOMAC. Similarly to cases associated with long-term CPA intake, tumor reduction, and improvement of clinical symptoms can be observed after cessation of NOMAC.

Authors+Show Affiliations

Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France. pierre_olivierc@hotmail.com.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.Department of Neurosurgery, Lariboisiere Hospital, University of Paris Diderot, 2 rue Ambroise Paré, 75010, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30783806

Citation

Passeri, Thibault, et al. "Spontaneous Regression of Meningiomas After Interruption of Nomegestrol Acetate: a Series of Three Patients." Acta Neurochirurgica, vol. 161, no. 4, 2019, pp. 761-765.
Passeri T, Champagne PO, Bernat AL, et al. Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients. Acta Neurochir (Wien). 2019;161(4):761-765.
Passeri, T., Champagne, P. O., Bernat, A. L., Hanakita, S., Salle, H., Mandonnet, E., & Froelich, S. (2019). Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients. Acta Neurochirurgica, 161(4), pp. 761-765. doi:10.1007/s00701-019-03848-x.
Passeri T, et al. Spontaneous Regression of Meningiomas After Interruption of Nomegestrol Acetate: a Series of Three Patients. Acta Neurochir (Wien). 2019;161(4):761-765. PubMed PMID: 30783806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients. AU - Passeri,Thibault, AU - Champagne,Pierre-Olivier, AU - Bernat,Anne-Laure, AU - Hanakita,Shunya, AU - Salle,Henri, AU - Mandonnet,Emmanuel, AU - Froelich,Sébastien, Y1 - 2019/02/19/ PY - 2019/01/10/received PY - 2019/02/12/accepted PY - 2019/2/21/pubmed PY - 2019/2/21/medline PY - 2019/2/21/entrez KW - Cyproterone acetate KW - Meningioma KW - Nomegestrol acetate KW - Progestational agonist SP - 761 EP - 765 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 161 IS - 4 N2 - BACKGROUND: The relationship between increased meningioma incidence and growth and long-term hormonal therapy with cyproterone acetate (CPA) in women has been recently established in literature. Following the raise in awareness from hormonal treatment, we describe a potential relationship between the progesterone agonist nomegestrol acetate (NOMAC) and meningioma growth. METHODS: After implementation of a screening protocol to detect potential interactions between hormonal exposure and occurrence of meningioma, we identified patients taking NOMAC and newly diagnosed with a meningioma. NOMAC was stopped and those patients were followed tightly both clinically and radiologically. Retrospective volumetric analysis of the tumors was performed on the imaging. RESULTS: Three patients were identified for the study. After cessation of the NOMAC, tumor shrinkage was documented for all meningiomas within the first month. Up to 70% of tumor volume reduction was observed during the first year of follow-up in one of them. None of the patients developed new symptoms. CONCLUSION: We report the first cases of meningiomas responsiveness to discontinuation of hormonal therapy with NOMAC. Similarly to cases associated with long-term CPA intake, tumor reduction, and improvement of clinical symptoms can be observed after cessation of NOMAC. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/30783806/Spontaneous_regression_of_meningiomas_after_interruption_of_nomegestrol_acetate:_a_series_of_three_patients L2 - https://dx.doi.org/10.1007/s00701-019-03848-x DB - PRIME DP - Unbound Medicine ER -