Estrogen and progesterone receptors in meningiomas

Abstract

Two-thirds of all meningiomas and four-fifths of intraspinal and sphenoidal meningiomas occur in women. Meningiomas frequently enlarge or become symptomatic during pregnancy or during the luteal phase of the menstrual cycle. There is an increased incidence of meningiomas in women with breast carcinoma. In a series of 23 patients with meningiomas, the authors assayed biopsy specimens of the tumor for the presence of estrogen (ER) and progesterone (PR) receptors, using glycerol density gradient centrifugation and dextran-coated charcoal techniques. Significant levels of ER were found in only 17% of the patients, while significant PR levels were detected in 39%. Only one of the 16 tumors from female patients had significant ER levels, whereas three of the seven tumors from men had significant ER levels. Eight of the 16 tumors in women had significant PR levels, whereas only one of the seven tumors in men had a significant PR level. Thus, three out of four tumors with definite ER were from men, whereas eight of nine tumors with definite PR were from women. Of the eight women whose tumors contained PR, three were premenopausal and five postmenopausal. The single tumor with high levels of PR in the male patient was histologically atypical. The results of this series were compared with six published series of sex steroid assays in meningiomas. These seven series were divided into two groups: one group included two reports from the same laboratories in France, and the other the remaining five reports. Much higher percentages of both ER- and PR-positive tumors were reported from the French group. The authors suggest that this discrepancy may be due to the use of preoperative glucocorticoid therapy in the series from the United States. Since meningiomas are known to enlarge during periods when levels of circulating progestins are high, the presence of significant quantities of PR in a high percentage of tumors may have therapeutic implications for recurrent, malignant, or incompletely excised tumors, or for medically fragile patients. Conversely, since meningiomas are not known to enlarge during the proliferative phase of the menstrual cycle or with exogenous estrogen therapy, the small number of tumors positive for ER may indicate that ER lacks clinical significance. High levels of PR found in a small group of histologically aggressive tumors in several series may indicate that hormonal therapy may be especially useful in this difficult subset of patients.

Meningiomas and hormonal receptors: immunohistochemical study in typical and non-typical tumors

“…In our study of 116 meningiomas, none of them display ER immunoreactivity. On the other hand, we find that the majority of meningiomas is immunoreactive for PR, in agreement with other authors [5][6][7][8]16,17 . The presence of PR and lack of ER has led to believe that these PRs are estrogen independent, unlike PRs present in other hormoneregulated tumors, such as breast and uterus.…”

“…It also permits retrospective studies with stored material and the detection of receptors even with small amount of tissue. The ER is undetectable in almost all of studies, using different techniques 6,10,16,17 . It appears that ER is actually devoid in this kind of tumors.…”

“…The majority of studies used receptor binding assays to detect the presence of ER and PR 5,6,10,14 . It has produced widely varied and confusing results, possible due to differences in the handling of tissue, variations in techniques, and criteria used in determining the receptor status based on levels of cytosolic receptor binding sites.…”

“…Also, it has been observed that these tumors often grow during pregnancy and luteal phase of the menstrual cycle 2 and there is an association between meningiomas and breast cancer and other tumors wich have hormonal dependency 3,4 . Based in these data, there have been many reports which have dealt with the presence of estrogen receptor (ER) and progesterone receptors (PR) in meningiomas [5][6][7][8][9][10][11][12][13][14][15] . In recent years, the development of monoclonal antibodies specific for steroid hormone receptors has permitted the detection of PR and ER direct in tissue.…”

Cryostat section assay of oestrogen and progesterone receptors in meningiomas: a clinicopathological study.

“…A recent review by Cahill et al found that the results of analysis of steroid hormone receptor in meningiomas fell into two main groups, depending on the presence of clinically important oestrogen receptor. 21 Interestingly, most of the reports describing high concentrations of oestrogen receptor binding in a large proportion of neoplasms originate from France.9122023 Various theories have been put forward to explain this.2123 These include differences in the techniques of tissue biopsy, freezing, duration of storage, and methods of homogenisation. These variables, however, have differed in other reports, which are unanimous in finding low or undetectable concentrations of oestrogen receptor.…”