Progesterone and Oestrogen Receptors in Meningiomas: Biochemical and Clinicopathological Considerations*

Abstract

Specific progesterone and oestrogen receptor proteins were evaluated by a dextran coated charcoal assay and Scatchard plot analysis in 20 intracranial meningiomas. Eleven tumours (55%) were progesterone receptor (PR) positive (mean 108 fmol/mg cytosol protein), whilst all were oestrogen receptor (ER) negative (ER < 10 fmol/mg cytosol protein). There were no trends to suggest a relationship between epidemiological data (patient age, sex and reproductive status in females) or meningioma location and size and the receptor status of the tumour. However, of the seven meningiomas that were histologically atypical, invasive or clinically recurred within 18 months, six were PR negative (PR < 10 fmol/mg cytosol protein). These results confirm that a large proportion of intracranial meningiomas contain significant amounts of specific PR protein and suggest that PR negative meningiomas are biologically more aggressive than PR positive meningiomas. They are also consistent with the hypotheses that PR proteins are not modulated by oestrogens acting through oestrogen receptors and that there are cytokinetic differences between sex hormone receptor proteins in meningioma and breast carcinoma. The full biochemical, cytological and clinical implication of these preliminary findings will, however, require further evaluation because of the unpredictable long‐term behaviour of intracranial meningiomas.

The Influence of Adjuvant Radiotherapy in Atypical and Anaplastic Meningiomas: A Series of 88 Patients in a Single Institution

“…The sex ratio male/female in our series was 1.1, contrary to meningioma WHO I, consistent with most series in the literature suggesting the inactivity of endocrinological influences in these aggressive variants (29,36,45,51,58,60).…”

Clinicopathologic Features of Aggressive Meningioma Emphasizing the Role of Radiotherapy in Treatment

“…Our series which shows a 68.8% male preponderance is consistent, at this point, with most series in the literature. This suggests that the endocrinological influences important in the genesis of benign meningiomas are not active in aggressive variants [15,20,27,29,30,38,40]. Regarding the tumor location, only five cases (31.25%) were basal meningiomas, while the majority of cases were convexity and parasagittal tumors as reported in most series of aggressive meningioma [6,10,27,30,40].…”

“…Although the 5-year recurrence rate after total removal is only 3-4% for benign meningiomas, it rises to 35-38% with atypical and 78-84% with anaplastic meningiomas [14,23,27]. 38.5% of our patients originally diagnosed as having atypical meningioma experienced recurrence in spite of total surgical resection within a relatively short period. The histology of recurrence was similarly grade II in two cases, unknown in one case (treated with FSRT), while in the other two cases, it progressed to malignant meningioma.…”

Risk Factors for Malignant and Atypical Meningiomas

“…Benign meningiomas have a high level of progesterone receptor expression relative to atypical and malignant meningiomas. Clinical and histopathologic studies have shown an inverse relationship between progesterone receptor expression level and both WHO grade and recurrence [21][22][23]. Risk for atypical and malignant changes increased with non skull base meningiomas.…”