Hemorrhagic onset of rhabdoid meningioma after initiating treatment for infertility

Motegi, Hiroaki; Kobayashi, Hiroyuki; Terasaka, Shunsuke; Ishii, Nobuaki; Ito, Masaki; Shimbo, Daisuke; Kubota, Kanako; Houkin, Kiyohiro

doi:10.1007/s10014-012-0088-y

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…Regarding histological classification, Grade II meningiomas included two clear cell meningiomas and one chordoid meningioma, and Grade III meningiomas included one papillary meningioma and one rhabdoid meningioma on which we have reported previously [7]. In this study, we included patients with HGMs that were transformed from benign (Grade I) meningiomas at first presentation.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Factors for Survival in Patients with High-Grade Meningioma and Recurrence-Risk Stratification for Application of Radiotherapy

et al. 2014

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BackgroundRadiotherapy for high-grade meningioma (HGM) is one of the essential treatment options for disease control. However, appropriate irradiation timing remains under debate. The object of this study is to discern which prognostic factors impact recurrence in HGM patients and to propose a risk-stratification system for the application of postoperative radiotherapy.MethodsWe retrospectively reviewed 55 adult patients who were diagnosed with Grade II and III intracranial meningioma. Cox regression models were applied to the analysis for impact on early recurrence in HGM patients without postoperative radiotherapy.ResultsGrade III malignancy (P = 0.0073) and transformed histology (P = 0.047) proved to be significantly poor prognostic factors of early recurrence by multivariate analysis. The other candidates for recurrence factors were Simpson Grade 3–5 resection, preoperative Karnofsky Performance status < = 70%, and MIB-1 labeling index > = 15%. According to these prognostic factors, postoperative HGM patients could be stratified into three recurrence-risk groups. The prognoses were significantly different between each group, as the 3-year actual recurrence-free rates were 90% in low-risk group, 31% in intermediate-risk group, and 15% in high-risk group.ConclusionWe propose recurrence-risk stratification for postoperative HGM patients using clinically available factors. Our results suggest that the prognosis for patients with high-risk HGMs is dismal, whereas HGM patients belonging to the low-risk group could have favorable prognoses. This stratification provides us with the criteria necessary to determine whether to apply adjuvant radiotherapy to postoperative HGM patients, and to also help identify potentially curable HGMs without adjuvant radiotherapy.

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Section: Methodsmentioning

confidence: 99%

Prognostic Factors for Survival in Patients with High-Grade Meningioma and Recurrence-Risk Stratification for Application of Radiotherapy

et al. 2014

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“…While studies investigating meningioma and fertility treatment are limited to retrospective case reports and one case-control study [10][11][12][13], the association of progesterone receptor expression and meningioma has been studied more extensively [30]. There are various situations in addition to fertility treatment where patients might be exposed to high dose estrogen or progesterone.…”

Section: Discussionmentioning

confidence: 99%

“…One large case control study found no association between fertility treatment and meningioma [10]. There have been three cases of meningioma diagnosed in women with a history of fertility treatment described in the literature [11][12][13]. Recently, Wengel et al identified eight transgender patients who developed meningioma during hormone therapy.…”

Section: Introductionmentioning

confidence: 99%

Fertility treatment is associated with multiple meningiomas and younger age at diagnosis

et al. 2019

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Purpose: Meningiomas are more common in females and 70-80% express the progesterone receptor, raising the possibility that high-dose exogenous estrogen/progesterone exposure, such as occurs during fertility treatments, may increase the risk of developing a meningioma. The goal of this study was to report the incidence of prior fertility treatment in a consecutive series of female meningioma patients. Methods: A retrospective review (2015-2018) was performed of female patients with meningioma, and those with prior fertility treatment were compared to those without fertility treatment using standard statistical methods. Results: Of 206 female patients with meningioma, 26 (12.6%) had a history of fertility treatments. Patients underwent various forms of assisted reproductive technology including: in vitro fertilization (50.0%), clomiphene with or without intrauterine insemination (34.6%), and unspecified (19.2%). Median follow up was 1.8 years. Tumors were WHO grade I (78.6%) or grade II (21.4%). Patients who underwent fertility treatments presented at significantly younger mean age compared to those who had not (51.8 vs 57.3 yrs, p = 0.0135, 2-tailed T-test), and on multivariate analysis were more likely to have multiple meningiomas (OR: 4.97, 95% CI: 1.4-18.1, p = 0.0154) and convexity/falx meningiomas (OR: 4.45, 95% CI: 1.7-11.5, p = 0.0021). Conclusions: Patients in this cohort with a history of fertility treatment were more likely to present at a younger age and have multiple and convexity/falx meningiomas, emphasizing the importance of taking estrogen/progesterone exposure history when evaluating patients with

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“…One case, for instance, reported on a 37-year-old right-handed female, with a prior history of three cycles of fertility treatment, who presented with a massive parasagittal meningioma [5]. A 29-year-old female presented with acute hemorrhage of a rhabdoid meningioma two weeks after initiating treatments of clomiphene citrate [6]. Furthermore, there have been multiple cases of meningiomas with accelerated growth during pregnancy [7, 8].…”

Section: Discussionmentioning

confidence: 99%

Fast-Growing Meningioma in a Woman Undergoing Fertility Treatments

Patterson

Elashaal

2016

Case Reports in Neurological Medicine

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Meningiomas have long been known to be associated with sexual hormones. We discuss here the case of a woman with a huge meningioma that rapidly grew over the course of a couple years while the patient was simultaneously taking fertility treatments. There is substantial evidence suggesting that fertility treatments can fuel the growth of meningiomas. The potential risks should be considered in women with a previous or family history of meningiomas who plan to undergo fertility treatment. These patients need to be evaluated and a screening imaging of brain MRI (Magnetic Resonant Imaging) should be offered in the middle or toward the end of such a treatment to control and prevent complications of these meningiomas.

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Hemorrhagic onset of rhabdoid meningioma after initiating treatment for infertility

Cited by 11 publications

References 17 publications

Prognostic Factors for Survival in Patients with High-Grade Meningioma and Recurrence-Risk Stratification for Application of Radiotherapy

Prognostic Factors for Survival in Patients with High-Grade Meningioma and Recurrence-Risk Stratification for Application of Radiotherapy

Fertility treatment is associated with multiple meningiomas and younger age at diagnosis

Fast-Growing Meningioma in a Woman Undergoing Fertility Treatments

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