Petroclival meningioma regression after combined oestrogen and nomegestrol acetate interruption.

Contraception; Drug therapy related to surgery; Neurooncology; Norpregnadienes; Megestrol; nomegestrol acetate; Estrogens; Humans; Female; Middle Aged; Magnetic Resonance Imaging; Estrogens/administration & dosage; Skull Base Neoplasms/drug therapy; Skull Base Neoplasms/diagnostic imaging; Neoplasm Regression, Spontaneous; Meningioma/drug therapy; Meningioma/diagnostic imaging; Norpregnadienes/therapeutic use; Norpregnadienes/administration & dosage; Megestrol/administration & dosage; Megestrol/therapeutic use; Meningeal Neoplasms/drug therapy

Abstract :

[en] Meningioma regression after progestin treatment interruption is already established. Zoely is a combined oral contraceptive including oestradiol and progestin (nomegestrol acetate). The effect of combined oestrogen with nomegestrol acetate on meningioma is currently unknown. We report the case of a woman in her early 50s under Zoely for 5 years who was diagnosed with a large petroclival meningioma. After cessation of Zoely, the patient showed clinical improvement and shrinkage of the tumour volume from 27.22 cm3 to 20.54 cm3 in 6 months. This is probably the first report of spontaneous meningioma regression after Zoely interruption.

Disciplines :

Neurology

Author, co-author :

LEBEAU, Julie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurochirurgie

Deprez, Louis ; Centre Hospitalier Universitaire de Liège - CHU > > Service médical de radiodiagnostic

Pintiaux, Axelle ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'endocrinologie clinique

Reuter, Gilles ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurochirurgie

Language :

English

Title :

Petroclival meningioma regression after combined oestrogen and nomegestrol acetate interruption.

Publication date :

19 January 2025

Journal title :

BMJ Case Reports

eISSN :

1757-790X

Publisher :

BMJ Publishing Group, England

Volume :

Issue :

Pages :

e263529

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://syndication.highwire.org/content/doi/10.1136/bcr-2024-263529

Available on ORBi :

since 24 February 2025

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Bibliography

Wiemels JL, Wrensch M, Claus EB. Epidemiology and etiology of meningioma. J Neurooncol 2010;99:307–14.
Kerr K, Qualmann K, Esquenazi Y, et al. Familial Syndromes Involving Meningiomas Provide Mechanistic Insight Into Sporadic Disease. Neurosurgery 2018;83:1107–18.
Degeneffe A, De Maertelaer V, De Witte O, et al. The Association Between Meningioma and Breast Cancer: A Systematic Review and Meta-analysis. JAMA Netw Open 2023;6:e2318620.
Umansky F, Shoshan Y, Rosenthal G, et al. Radiation-induced meningioma. Neurosurg Focus 2008;24:E7.
Dolecek TA, Dressler EVM, Thakkar JP, et al. Epidemiology of meningiomas post-Public Law 107-206: The Benign Brain Tumor Cancer Registries Amendment Act. Cancer 2015;121:2400–10.
Khazanchi R, Nandoliya KR, Shahin MN, et al. Obesity and meningioma: a US population-based study paired with analysis of a multi-institutional cohort. J Neurosurg 2024;140:1558–67.
Hoisnard L, Laanani M, Passeri T, et al. Risk of intracranial meningioma with three potent progestogens: A population-based case-control study. Eur J Neurol 2022;29:2801–9.
Roland N, Neumann A, Hoisnard L, et al. Utilisation de progestatifs et risque de méningiome intracrânien: une étude cas-témoins à partir des données du Système national des données de santé (SNDS). J Epidemiol Popul Health 2024;72:202290.
Bernat AL, Bonnin S, Labidi M, et al. Regression of Giant Olfactory Groove Meningioma and Complete Visual Acuity Recovery after Discontinuation of Cyproterone Acetate. J Ophthalmic Vis Res 2018;13:355–8.
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;157:1741–6.
Cebula H, Pham TQ, Boyer P, et al. Regression of meningiomas after discontinuation of cyproterone acetate in a transsexual patient. Acta Neurochir (Wien) 2010;152:1955–6.
Gonçalves AMG, Page P, Domigo V, et al. Abrupt regression of a meningioma after discontinuation of cyproterone treatment. AJNR Am J Neuroradiol 2010;31:1504–5.
Malaize H, Samoyeau T, Zanello M, et al. Evolution of the neurosurgical management of progestin-associated meningiomas: a 23-year single-center experience. J Neurooncol 2021;152:279–88.
Portet S, Banor T, Bousquet J, et al. New Insights into Expression of Hormonal Receptors by Meningiomas. World Neurosurg 2020;140:e87–96.
Agopiantz M, Carnot M, Denis C, et al. Hormone Receptor Expression in Meningiomas: A Systematic Review. Cancers (Basel) 2023;15:980.
Pravdenkova S, Al-Mefty O, Sawyer J, et al. Progesterone and estrogen receptors: opposing prognostic indicators in meningiomas. J Neurosurg 2006;105:163–73.
Hsu DW, Efird JT, Hedley-Whyte ET. Progesterone and estrogen receptors in meningiomas: prognostic considerations. J Neurosurg 1997;86:113–20.
Liu F, Chen W, Chen J. Letter to the Editor. Is there any relationship between estrogen receptor/progesterone receptor status and recurrence of meningioma? J Neurosurg 2018;128:1899–901.
Carroll RS, Zhang J, Dashner K, et al. Androgen receptor expression in meningiomas. J Neurosurg 1995;82:453–60.
Giraldi L, Heerfordt IM, Windfeld-Mathiasen J, et al. Extensive androgen exposure and meningioma risk - A matched cohort study. Clin Neurol Neurosurg 2024;239:108217.
Samarut E, Lugat A, Amelot A, et al. Meningiomas and cyproterone acetate: a retrospective, monocentric cohort of 388 patients treated by surgery or radiotherapy for intracranial meningioma. J Neurooncol 2021;152:115–23.
Cea-Soriano L, Blenk T, Wallander M-A, et al. Hormonal therapies and meningioma: is there a link? Cancer Epidemiol 2012;36:198–205.
Hatch EE, Linet MS, Zhang J, et al. Reproductive and hormonal factors and risk of brain tumors in adult females. Int J Cancer 2005;114:797–805.
Custer B, Longstreth WT Jr, Phillips LE, et al. Hormonal exposures and the risk of intracranial meningioma in women: a population-based case-control study. BMC Cancer 2006;6:152.
Lee E, Grutsch J, Persky V, et al. Association of meningioma with reproductive factors. Int J Cancer 2006;119:1152–7.
Claus EB, Calvocoressi L, Bondy ML, et al. Exogenous hormone use, reproductive factors, and risk of intracranial meningioma in females. J Neurosurg 2013;118:649–56.
Korhonen K, Raitanen J, Isola J, et al. Exogenous sex hormone use and risk of meningioma: a population-based case-control study in Finland. Cancer Causes Control 2010;21:2149–56.
Dresser L, Yuen CA, Wilmington A, et al. Estrogen hormone replacement therapy in incidental intracranial meningioma: a growth-rate analysis. Sci Rep 2020;10:17960.
Weill A, Nguyen P, Labidi M, et al. Use of high dose cyproterone acetate and risk of intracranial meningioma in women: cohort study. BMJ 2021;372:n37.
Nguyen P. Utilisation prolongée de l’acétate de chlormadinone et risque de méningiome intracrânien: une étude de cohorte à partir des données du SNDS. EPIPHARE, ema.europa.eu; 2021.
Nguyen P. Utilisation prolongée de l’acétate de nomégestrol et risque de méningiome intracrânien: une étude de cohorte à partir des données du SNDS. EPI-PHARE in ema. europa.eu; 2021.
Nguyen P, Roland N, Neumann A, et al. Prolonged use of nomegestrol acetate and risk of intracranial meningioma: a population-based cohort study. Lancet Reg Health Eur 2024;42:100928.
Kerschbaumer J, Freyschlag CF, Stockhammer G, et al. Hormone-dependent shrinkage of a sphenoid wing meningioma after pregnancy: case report. J Neurosurg 2016;124:137–40.
Passeri T, Champagne P-O, Bernat A-L, et al. Spontaneous regression of meningiomas after interruption of nomegestrol acetate: a series of three patients. Acta Neurochir (Wien) 2019;161:761–5.
Behbahani M, Skeie GO, Eide GE, et al. A prospective study of the natural history of incidental meningioma-Hold your horses! Neurooncol Pract 2019;6:438–50.
von Stockum S, Becker K, Bauerfeind A, et al. NOMAC-E2 compares to LNG combined oral contraceptives in women over forty: real-world PRO-E2 study. Gynecol Endocrinol 2023;39:2166032.
Grandi G, Di Vinci P, Sgandurra A, et al. Contraception During Perimenopause: Practical Guidance. Int J Womens Health 2022;14:913–29.
Troìa L, Martone S, Morgante G, et al. Management of perimenopause disorders: hormonal treatment. Gynecol Endocrinol 2021;37:195–200.
Pintiaux A, Gaspard U, Nisolle M. Zoely, a combined oral contraceptive, monophasic pill containing estradiol and nomegestrol acetate. Rev Med Liege 2012;67:152–6.