Regression of multiple meningiomata after cessation of cyproterone acetate treatment
General Surgery (East Africa)
Objectives: We report a case of regression of multiple meningiomata after cessation of cyproterone acetate treatment.
Design: Case report and PubMed review of the literature.
Subjects: A 59-year-old man had been on prolonged cyproterone for hypersexuality. He presented with 6 months increasing right-sided headaches and right-eye proptosis. He also had early signs of right optic nerve edema. MRI showed multiple meningiomata with the largest being over the right sphenoid wing. Cyproterone was discontinued.
Methods: Patient review in outpatients with serial MRI scans and PubMed search using the terms “meningioma” and “cyproterone acetate” or “hormone” and “regression.”
Results: Within 3 months of discontinuing cyproterone, the patient had marked clinical and radiological regression of his meningiomas. He has been reviewed with three monthly MRI scans for 1 year, and his symptoms have clinically resolved. So far, he has not required surgery and his hypersexuality is being effectively managed with Zoladex. Our literature review indicates a clinical association of meningioma formation with long-term cyproterone use. There are only two similar cases of tumor regression on cessation of cyproterone treatment.
Conclusions: This case illustrates how cyproterone may result in hormone-receptive meningiomata growth. It also shows how discontinuing the cyproterone has so far resulted in clinical resolution of symptoms and radiological tumor regression in this case.
Publication (Name of Journal)
Journal of Neurological Surgery Part B: Skull Base
Cheserem, J., Zebian, B., Macdonald, M., & Hardwidge, C. (2012). Regression of multiple meningiomata after cessation of cyproterone acetate treatment. Journal of Neurological Surgery Part B: Skull Base, 73(S 02), A314.
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