Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients

Abstract

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.

Regression of giant olfactory groove meningioma and complete visual acuity recovery after discontinuation of cyproterone acetate

“…Development and growth of de novo tumors has previously been observed in patients treated with CA. [ 1 2 3 ] A reduction in lesion volume has been documented in most cases following discontinuation of CA[ 1 2 3 ] and we have confirmed this phenomen in our own case series of CA-associated meningiomas. [ 1 ]…”

“…In our larger series of CA-associated meningiomas, we recommended surgical treatment of meningiomas that threaten the functional prognosis, which was the case for 2 patients included in the series. [ 1 ] In the present patient, we initially opted for regular ophthalmic monitoring and to reserve surgery as a second-line option; the rapid recovery of her VA confirmed the appropriateness of this therapeutic strategy, although surgery would have been a viable option for this otherwise quite large tumor. During follow-up, we observed a slight bilateral decrease in temporal retinal nerve fiber layer thickness on optical coherence tomography, which was the result of a mass effect.…”

“…Progesterone receptors are strongly expressed in about two-thirds of meningiomas, but little is known about their precise role in tumorigenesis. We have previously reported the association between cyproterone acetate (CA),[ 1 ] a progesterone agonist, and development of de novo meningioma as well as an increased growth rate. We have observed that the volume of most meningiomas is reduced following discontinuation of the drug.…”

Establishing the Proper Approach to an Effective Surgical Treatment for Meningioma

“…In some patients diagnosed with meningiomas, 80% decrease in the tumor volume was reported after hormone therapy interruption. Moreover, meningiomas spontaneously decreased after pregnancy [9][10][11]. Radiation therapy, systemic therapy and surgery are the available treatment options for treating meningioma.…”

Characteristics of anesthetic tactics for labor and delivery in pregnant women with brain neoplasms

“…Искусственную вентиляцию легких при общей анестезии проводят в условиях нормовентиляции. Не следует применять режимы положительного давления в конце выдоха, а также устанавливать параметры, которые повышают среднее давление в дыхательных путях (например, высокая частота дыхания и малый дыхательный объем), что способствует увеличению центрального венозного давления и, как следствие, внутричерепного [6,14,15].…”