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Guo AX, Job A, Pacione D, Agrawal N. Risk of intracranial meningioma in patients with acromegaly: a systematic review. Front Endocrinol (Lausanne) 2024; 15:1407615. [PMID: 38919490 PMCID: PMC11196394 DOI: 10.3389/fendo.2024.1407615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Acromegaly is a rare endocrine disorder caused by hypersecretion of growth hormone (GH) from a pituitary adenoma. Elevated GH levels stimulate excess production of insulin-like growth factor 1 (IGF-1) which leads to the insidious onset of clinical manifestations. The most common primary central nervous system (CNS) tumors, meningiomas originate from the arachnoid layer of the meninges and are typically benign and slow-growing. Meningiomas are over twice as common in women as in men, with age-adjusted incidence (per 100,000 individuals) of 10.66 and 4.75, respectively. Several reports describe co-occurrence of meningiomas and acromegaly. We aimed to determine whether patients with acromegaly are at elevated risk for meningioma. Investigation of the literature showed that co-occurrence of a pituitary adenoma and a meningioma is a rare phenomenon, and the majority of cases involve GH-secreting adenomas. To the best of our knowledge, a systematic review examining the association between meningiomas and elevated GH levels (due to GH-secreting adenomas in acromegaly or exposure to exogenous GH) has never been conducted. The nature of the observed coexistence between acromegaly and meningioma -whether it reflects causation or mere co-association -is unclear, as is the pathophysiologic etiology. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42022376998.
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Affiliation(s)
- Amy X. Guo
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
| | - Asha Job
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
| | - Donato Pacione
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
- Division of Neurosurgery, NYU Langone Health, New York, NY, United States
| | - Nidhi Agrawal
- NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
- Division of Endocrinology, Diabetes and Metabolism, NYU Langone Medical Center/Bellevue Hospital Center New York, New York, NY, United States
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2
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Roland N, Neumann A, Hoisnard L, Duranteau L, Froelich S, Zureik M, Weill A. Use of progestogens and the risk of intracranial meningioma: national case-control study. BMJ 2024; 384:e078078. [PMID: 38537944 PMCID: PMC10966896 DOI: 10.1136/bmj-2023-078078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To assess the risk of intracranial meningioma associated with the use of selected progestogens. DESIGN National case-control study. SETTING French National Health Data System (ie, Système National des Données de Santé). PARTICIPANTS Of 108 366 women overall, 18 061 women living in France who had intracranial surgery for meningioma between 1 January 2009 and 31 December 2018 (restricted inclusion periods for intrauterine systems) were deemed to be in the case group. Each case was matched to five controls for year of birth and area of residence (90 305 controls). MAIN OUTCOME MEASURES Selected progestogens were used: progesterone, hydroxyprogesterone, dydrogesterone, medrogestone, medroxyprogesterone acetate, promegestone, dienogest, and intrauterine levonorgestrel. For each progestogen, use was defined by at least one dispensation within the year before the index date (within three years for 13.5 mg levonorgestrel intrauterine systems and five years for 52 mg). Conditional logistic regression was used to calculate odds ratio for each progestogen meningioma association. RESULTS Mean age was 57.6 years (standard deviation 12.8). Analyses showed excess risk of meningioma with use of medrogestone (42 exposed cases/18 061 cases (0.2%) v 79 exposed controls/90 305 controls (0.1%), odds ratio 3.49 (95% confidence interval 2.38 to 5.10)), medroxyprogesterone acetate (injectable, 9/18 061 (0.05%) v 11/90 305 (0.01%), 5.55 (2.27 to 13.56)), and promegestone (83/18 061 (0.5%) v 225/90 305 (0.2 %), 2.39 (1.85 to 3.09)). This excess risk was driven by prolonged use (≥one year). Results showed no excess risk of intracranial meningioma for progesterone, dydrogesterone, or levonorgestrel intrauterine systems. No conclusions could be drawn concerning dienogest or hydroxyprogesterone because of the small number of individuals who received these drugs. A highly increased risk of meningioma was observed for cyproterone acetate (891/18 061 (4.9%) v 256/90 305 (0.3%), odds ratio 19.21 (95% confidence interval 16.61 to 22.22)), nomegestrol acetate (925/18 061 (5.1%) v 1121/90 305 (1.2%), 4.93 (4.50 to 5.41)), and chlormadinone acetate (628/18 061 (3.5%) v 946/90 305 (1.0%), 3.87 (3.48 to 4.30)), which were used as positive controls for use. CONCLUSIONS Prolonged use of medrogestone, medroxyprogesterone acetate, and promegestone was found to increase the risk of intracranial meningioma. The increased risk associated with the use of injectable medroxyprogesterone acetate, a widely used contraceptive, and the safety of levonorgestrel intrauterine systems are important new findings.
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Affiliation(s)
- Noémie Roland
- EPI-PHARE Scientific Interest Group, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Anke Neumann
- EPI-PHARE Scientific Interest Group, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Léa Hoisnard
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
| | - Lise Duranteau
- Department of Medical Gynaecology, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, 94270, Le Kremlin-Bicêtre, France
| | - Sébastien Froelich
- Department of Neurosurgery, Lariboisière University Hospital, Paris-Cité University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mahmoud Zureik
- EPI-PHARE Scientific Interest Group, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
- University Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Alain Weill
- EPI-PHARE Scientific Interest Group, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
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Caruso G, Ferrarotto R, Curcio A, Metro L, Pasqualetti F, Gaviani P, Barresi V, Angileri FF, Caffo M. Novel Advances in Treatment of Meningiomas: Prognostic and Therapeutic Implications. Cancers (Basel) 2023; 15:4521. [PMID: 37760490 PMCID: PMC10526192 DOI: 10.3390/cancers15184521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Meningiomas are the most frequent histotypes of tumors of the central nervous system. Their incidence is approximately 35% of all primary brain tumors. Although they have the status of benign lesions, meningiomas are often associated with a decreased quality of life due to focal neurological deficits that may be related. The optimal treatment is total resection. Histological grading is the most important prognostic factor. Recently, molecular alterations have been identified that are specifically related to particular phenotypes and, probably, are also responsible for grading, site, and prognostic trend. Meningiomas recur in 10-25% of cases. In these cases, and in patients with atypical or anaplastic meningiomas, the methods of approach are relatively insufficient. To date, data on the molecular biology, genetics, and epigenetics of meningiomas are insufficient. To achieve an optimal treatment strategy, it is necessary to identify the mechanisms that regulate tumor formation and progression. Combination therapies affecting multiple molecular targets are currently opening up and have significant promise as adjuvant therapeutic options. We review the most recent literature to identify studies investigating recent therapeutic treatments recently used for meningiomas.
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Affiliation(s)
- Gerardo Caruso
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Rosamaria Ferrarotto
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Antonello Curcio
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Luisa Metro
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | | | - Paola Gaviani
- Neuro Oncology Unit, IRCCS Foundation Carlo Besta Neurological Institute, 20133 Milan, Italy;
| | - Valeria Barresi
- Department of Diagnostics and Public Health, Section of Pathology, University of Verona, 37134 Verona, Italy;
| | - Filippo Flavio Angileri
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
| | - Maria Caffo
- Biomedical and Dental Sciences and Morphofunctional Imaging, Unit of Neurosurgery, University of Messina, 98122 Messina, Italy; (R.F.); (A.C.); (L.M.); (F.F.A.); (M.C.)
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4
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Uhlmann EJ, Mackel CE, Deforzh E, Rabinovsky R, Brastianos PK, Varma H, Vega RA, Krichevsky AM. Inhibition of the epigenetically activated miR-483-5p/IGF-2 pathway results in rapid loss of meningioma tumor cell viability. J Neurooncol 2023; 162:109-118. [PMID: 36809604 PMCID: PMC10050031 DOI: 10.1007/s11060-023-04264-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Meningioma is the most common primary central nervous system tumor often causing serious complications, and presently no medical treatment is available. The goal of this study was to discover miRNAs dysregulated in meningioma, and explore miRNA-associated pathways amenable for therapeutic interventions. METHODS Small RNA sequencing was performed on meningioma tumor samples to study grade-dependent changes in microRNA expression. Gene expression was analyzed by chromatin marks, qRT-PCR and western blot. miRNA modulation, anti-IGF-2 neutralizing antibodies, and inhibitors against IGF1R were evaluated in a tumor-derived primary cultures of meningioma cells. RESULTS Meningioma tumor samples showed high, grade-dependent expression of miR-483-5p, associated with high mRNA and protein expression of its host gene IGF-2. Inhibition of miR-483-5p reduced the growth of cultured meningioma cells, whereas a miR-483 mimic increased cell proliferation. Similarly, inhibition of this pathway with anti-IGF-2 neutralizing antibodies reduced meningioma cell proliferation. Small molecule tyrosine kinase inhibitor blockade of the IGF-2 receptor (IGF1R) resulted in rapid loss of viability of cultured meningioma tumor-derived cells, suggesting that autocrine IGF-2 feedback is obligatory for meningioma tumor cell survival and growth. The observed IGF1R-inhibitory IC50 for GSK1838705A and ceritinib in cell-based assays along with the available pharmacokinetics data predicted that effective drug concentration could be achieved in vivo as a new medical treatment of meningioma. CONCLUSION Meningioma cell growth is critically dependent on autocrine miR-483/IGF-2 stimulation and the IGF-2 pathway provides a feasible meningioma treatment target.
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Affiliation(s)
- Erik J Uhlmann
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
| | - Charles E Mackel
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA
| | - Evgeny Deforzh
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Rosalia Rabinovsky
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Priscilla K Brastianos
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Hemant Varma
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Rafael A Vega
- Department of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA
| | - Anna M Krichevsky
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
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5
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Agopiantz M, Carnot M, Denis C, Martin E, Gauchotte G. Hormone Receptor Expression in Meningiomas: A Systematic Review. Cancers (Basel) 2023; 15:cancers15030980. [PMID: 36765937 PMCID: PMC9913299 DOI: 10.3390/cancers15030980] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Meningiomas are, in most cases, low grade intracranial tumors. However, relapses are frequent. To date, only a few prognostic markers are described in the literature. Several studies have discussed the expression of progesterone, estrogen, androgen, and somatostatin receptors. The utility of analyzing these expressions for prognostic, theragnostic, and therapeutic purposes remains unclear. The aim of this study was to report the expression of these receptors, based on immunohistochemistry. Cochrane Collaboration guidelines and PRISMA statements were followed. We did an online search in PubMed using the MeSH database. References were selected if the investigations occurred from 1990 to 2022. 61 references were included (34 descriptive observational studies, 26 analytical observational studies, and one case report). In this review, we describe the expression of these receptors in function of age, sex, hormonal context, localization, histological subtype, grade, and recurrence.
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Affiliation(s)
- Mikaël Agopiantz
- Department of Assisted Reproductive Technologies, CHRU de Nancy, 54000 Nancy, France
- Faculty of Medicine of Nancy, Université de Lorraine, INSERM UMRS 1256, Nutrition, Genetics and Environmental Risk Exposure (NGERE), 54000 Nancy, France
| | - Mélanie Carnot
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Constance Denis
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Elena Martin
- Department of Medical Gynecology, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France
| | - Guillaume Gauchotte
- Faculty of Medicine of Nancy, Université de Lorraine, INSERM UMRS 1256, Nutrition, Genetics and Environmental Risk Exposure (NGERE), 54000 Nancy, France
- Department of Biopathology CHRU-ICL, CHRU de Nancy, 54500 Vandoeuvre-lès-Nancy, France
- Correspondence: ; Tel.: +33-3-83-65-60-17
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6
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Chen Y, Tian S, Wang J, Liang Z, Wang B, Zhao Y, Ma J. Lateral ventricle meningiomas in children: clinicopathological and neuroradiological features. Childs Nerv Syst 2023; 39:151-158. [PMID: 36316483 DOI: 10.1007/s00381-022-05680-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/15/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Lateral ventricle meningiomas (LVM) in children are very rare. The current research is mostly limited to adults, and there are very few related studies on children. The purpose of this study was to analyze the clinicopathological and imaging features of lateral ventricle meningiomas in children. METHODS A retrospective analysis of five children with pathologically confirmed lateral ventricle meningioma was performed, and we collected clinical data, including clinicopathological data, treatment prognosis data, and imaging features (including tumor location, signal intensity, enhancement degree, intratumoral cyst, calcification, peritumoral edema, and associated hydrocephalus). RESULTS Among the 5 patients with LVM, 4 were male and 1 was female with an average age of 7.6 years (range 2 to 12 years). All CT scans showed slight hyperintensity or isodensity, and only 1 patient had calcification. Two patients demonstrated cyst changes. Four patients had varying degrees of peritumoral edema. The average tumor volume was 164.1 cm3 (1.4-314.9 cm3). All 5 patients with LVM were iso- or hypointense on T1WI. The T2WI signals had no obvious features. Four patients had a high signal on DWI (80%). The contrast-enhanced signals were mostly homogeneously strong (80%). MRI showed hydrocephalus in 3 patients. All patients underwent gross total resection, and they were followed up regularly after the operation. The average follow-up time was 47.4 months. No recurrence was found in any of the children. All patients were pathologically confirmed to have meningiomas, and WHO grades were all grade I. CONCLUSION Lateral ventricle meningiomas in children are very rare, and the imaging manifestations of the tumor have certain characteristics, but the clinical diagnosis is still difficult, and the diagnosis still requires pathological analysis.
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Affiliation(s)
- Yufan Chen
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Shuaiwei Tian
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jiajia Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Zhuangzhuang Liang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Baocheng Wang
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yang Zhao
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Jie Ma
- Department of Pediatric Neurosurgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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Dires Fenta B, Israel Korga T, Dinka Bikila T, Kassahun Tadele A, Lijalem Yigezu B, Gosa Negash M. Primary Intraosseous Meningioma: Bifrontal Skull Mass. PATHOLOGY AND LABORATORY MEDICINE INTERNATIONAL 2022. [DOI: 10.2147/plmi.s388172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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8
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Maier AD. Malignant meningioma. APMIS 2022; 130 Suppl 145:1-58. [DOI: 10.1111/apm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
- Department of Pathology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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9
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Deng J, Hua L, Bian L, Chen H, Chen L, Cheng H, Dou C, Geng D, Hong T, Ji H, Jiang Y, Lan Q, Li G, Liu Z, Qi S, Qu Y, Shi S, Sun X, Wang H, You Y, Yu H, Yue S, Zhang J, Zhang X, Wang S, Mao Y, Zhong P, Gong Y. Molecular diagnosis and treatment of meningiomas: an expert consensus (2022). Chin Med J (Engl) 2022; 135:1894-1912. [PMID: 36179152 PMCID: PMC9746788 DOI: 10.1097/cm9.0000000000002391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
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Affiliation(s)
- Jiaojiao Deng
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Lingyang Hua
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
| | - Liuguan Bian
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hong Chen
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ligang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China
| | - Hongwei Cheng
- Department of Neurosurgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China
| | - Changwu Dou
- Department of Neurosurgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia 750306, China
| | - Dangmurenjiapu Geng
- Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830011, China
| | - Tao Hong
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, China
| | - Hongming Ji
- Department of Neurosurgery, Shanxi Medical University Shanxi Provincial People's Hospital, Taiyuan, Shanxi 030012, China
| | - Yugang Jiang
- Department of Neurosurgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Qing Lan
- Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, Soochow, Jiangsu 215004, China
| | - Gang Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, Shandong 250063, China
| | - Zhixiong Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China
| | - Songtao Qi
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Yan Qu
- Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi 710038, China
| | - Songsheng Shi
- Department of Neurosurgery, Fujian Medical University Affiliated Union Hospital, Fuzhou, Fujian 350001, China
| | - Xiaochuan Sun
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - Haijun Wang
- Department of Neurosurgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China
| | - Yongping You
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Hualin Yu
- Department of Neurosurgery, Kunming Medical University First Affiliated Hospital, Kunming, Yunnan 650032, China
| | - Shuyuan Yue
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jianming Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China
| | - Xiaohua Zhang
- Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Shuo Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ping Zhong
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai 200040, China
- Neurosurgical Institute of Fudan University, Shanghai 200040, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai 200040, China
| | - Ye Gong
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai 200040, China
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10
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Boutry J, Tissot S, Ujvari B, Capp JP, Giraudeau M, Nedelcu AM, Thomas F. The evolution and ecology of benign tumors. Biochim Biophys Acta Rev Cancer 2021; 1877:188643. [PMID: 34715267 DOI: 10.1016/j.bbcan.2021.188643] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 12/12/2022]
Abstract
Tumors are usually classified into two main categories - benign or malignant, with much more attention being devoted to the second category given that they are usually associated with more severe health issues (i.e., metastatic cancers). Here, we argue that the mechanistic distinction between benign and malignant tumors has narrowed our understanding of neoplastic processes. This review provides the first comprehensive discussion of benign tumors in the context of their evolution and ecology as well as interactions with their hosts. We compare the genetic and epigenetic profiles, cellular activities, and the involvement of viruses in benign and malignant tumors. We also address the impact of intra-tumoral cell composition and its relationship with the tumoral microenvironment. Lastly, we explore the differences in the distribution of benign and malignant neoplasia across the tree of life and provide examples on how benign tumors can also affect individual fitness and consequently the evolutionary trajectories of populations and species. Overall, our goal is to bring attention to the non-cancerous manifestations of tumors, at different scales, and to stimulate research on the evolutionary ecology of host-tumor interactions on a broader scale. Ultimately, we suggest that a better appreciation of the differences and similarities between benign and malignant tumors is fundamental to our understanding of malignancy both at mechanistic and evolutionary levels.
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Affiliation(s)
- Justine Boutry
- CREEC/CANECEV, MIVEGEC (CREES), University of Montpellier, CNRS, IRD, Montpellier, France
| | - Sophie Tissot
- CREEC/CANECEV, MIVEGEC (CREES), University of Montpellier, CNRS, IRD, Montpellier, France
| | - Beata Ujvari
- Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin, University, Vic., Australia
| | - Jean-Pascal Capp
- Toulouse Biotechnology Institute, University of Toulouse, INSA, CNRS, INRAE, Toulouse, France
| | - Mathieu Giraudeau
- CREEC/CANECEV, MIVEGEC (CREES), University of Montpellier, CNRS, IRD, Montpellier, France; LIENSs, UMR 7266 CNRS-La Rochelle Université, 2 Rue Olympe de Gouges, 17000 La Rochelle, France
| | - Aurora M Nedelcu
- Department of Biology, University of New Brunswick, Fredericton, New Brunswick, E3B 5A3, Canada
| | - Frédéric Thomas
- CREEC/CANECEV, MIVEGEC (CREES), University of Montpellier, CNRS, IRD, Montpellier, France.
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11
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The risk of developing a meningioma during and after pregnancy. Sci Rep 2021; 11:9153. [PMID: 33911184 PMCID: PMC8080659 DOI: 10.1038/s41598-021-88742-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/09/2021] [Indexed: 01/01/2023] Open
Abstract
Pregnancy has been associated with diagnosis or growth of meningiomas in several case reports, which has led to the hypothesis that pregnancy may be a risk factor for meningiomas. The aim of this study was to test this hypothesis in a large population-based cohort study. Women born in Sweden 1958–2000 (N = 2,204,126) were identified and matched with the Medical Birth Register and the Cancer Register. The expected number of meningioma cases and risk ratios were calculated for parous and nulliparous women and compared to the observed number of cases. Compared to parous women, meningiomas were more common among nulliparous (SIR = 1.73; 95% CI 1.52–1.95). The number of meningioma cases detected during pregnancy was lower than the expected (SIR = 0.40; 95% CI 0.20–0.72). Moreover, no increased risk was found in the first-year post-partum (SIR = 1.04; 95% CI 0.74–1.41). Contrary to our hypothesis, there was no increased risk for diagnosing a meningioma during pregnancy or 1-year post-partum. A lower detection rate during pregnancy, may reflect under-utilization of diagnostic procedures, but the actual number of meningiomas was homogenously lower among parous than nulliparous women throughout the study period, indicating that pregnancy is not a risk factor for meningioma.
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12
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Engelhardt J, Nunes ML, Pouchieu C, Ferrière A, San-Galli F, Gimbert E, Vignes JR, Laurent F, Berge J, Baldi I, Tabarin A, Loiseau H. Increased Incidence of Intracranial Meningiomas in Patients With Acromegaly. Neurosurgery 2021; 87:639-646. [PMID: 31625569 DOI: 10.1093/neuros/nyz438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/04/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND An increased incidence of various neoplasms has been described in patients with acromegaly, and there is evidence to suggest that growth factors are risk factors for the development of meningiomas. OBJECTIVE To study if patients with acromegaly are more at risk for developing intracranial meningiomas. METHODS We conducted an observational study on 221 consecutive acromegalic patients recruited between January 1, 2000 and December 31, 2015, and 357 consecutive patients with a nonsomatotropic pituitary adenoma recruited between March 1, 2015 and December 31, 2016, in our institution. Patients underwent a gadolinium-enhanced 3D T1 brain magnetic resonance imaging to look for meningiomas. The proportion of meningiomas was compared between the 2 groups, and the standardized incidence ratio (SIR) was computed from the incidence rates of meningiomas observed in the population of acromegalic patients and compared to that of the general population given by the local registry of central nervous system tumors. RESULTS Patients with acromegaly had a significant risk for developing intracranial meningiomas as compared to patients without acromegaly (7.7% vs 2.2%, P = .005, OR = 3.45 [1.46; 8.15]). There was a significant increased incidence of intracranial meningiomas in patients with acromegaly (SIR = 126 [25; 367]) as compared to the general population. CONCLUSION Our study suggests strongly that patients with acromegaly are more at risk for developing intracranial meningiomas.
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Affiliation(s)
- Julien Engelhardt
- Department of Neurosurgery, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Marie-Laure Nunes
- Department of Endocrinology, Hôpital du Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Camille Pouchieu
- Bordeaux Population Health Research Center, Team Epicene, UMR 1219, University of Bordeaux, INSERM, Bordeaux, France
| | - Amandine Ferrière
- Department of Endocrinology, Hôpital du Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - François San-Galli
- Department of Neurosurgery, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Edouard Gimbert
- Department of Neurosurgery, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Jean-Rodolphe Vignes
- Department of Neurosurgery, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - François Laurent
- Department of Thoracic, Digestive and Endocrine Imaging, Hôpital du Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Jérôme Berge
- Department of Diagnostic and Interventional Neuroradiology, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France
| | - Isabelle Baldi
- Bordeaux Population Health Research Center, Team Epicene, UMR 1219, University of Bordeaux, INSERM, Bordeaux, France
| | - Antoine Tabarin
- Department of Endocrinology, Hôpital du Haut-Lévêque, Bordeaux University Hospital, Pessac, France
| | - Hugues Loiseau
- Department of Neurosurgery, Hôpital Pellegrin, Bordeaux University Hospital, Bordeaux, France.,EA 7435 - IMOTION, University of Bordeaux, Bordeaux, France
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13
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Hanna R, Feldman AM, Keller CE, Siddiqui MS. A Grade I Intracranial Meningioma with Metastasis to Multiple Vertebral Bodies: A Case Report and Literature Review. Cureus 2020; 12:e11477. [PMID: 33329973 PMCID: PMC7734695 DOI: 10.7759/cureus.11477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
World Health Organization (WHO) grade I meningiomas are slow-growing and typically benign brain tumors that can often be easily removed by surgery and rarely become malignant. We report the case of a WHO grade I meningioma in a 67-year-old man with multiple extracranial metastases.
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Affiliation(s)
- Renee Hanna
- Radiation Oncology, Henry Ford Health System, Detroit, USA
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14
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Winter RC, Antunes ACM, de Oliveira FH. The relationship between vascular endothelial growth factor and histological grade in intracranial meningioma. Surg Neurol Int 2020; 11:328. [PMID: 33194262 PMCID: PMC7655995 DOI: 10.25259/sni_528_2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background Meningioma is the most common benign intracranial neoplasm, accounting for 30% of all primary brain tumors. In 90% of cases, meningiomas are benign. Several aspects of molecular biology, including potential biomarkers, have been studied in attempts to better understand the natural history of meningiomas. Vascular endothelial growth factor (VEGF) is a biomarker responsible for inducing physiological and pathological angiogenesis. VEGF expression has been investigated as a potential predictor of several tumor aspects, including growth rate, recurrence rate, brain tissue invasion, peritumoral edema and surgical prognosis, and also as a marker of histological grade. However, there is no consensus in the literature with respect to the association between this biological factor and meningioma. We digitally analyzed immunohistochemical images using ImageJ software with the aim of correlating VEGF expression with tumor histology. Methods Tissue samples from patients presenting with meningioma who had undergone surgical removal between 2007 and 2016 at the Hospital de Clínicas de Porto Alegre (HCPA), in Southern Brazil, were analyzed to identify possible immunohistochemical associations between VEGF and histological grade and subtype. Results Seventy-six patients were included; 82% were female, mean age was 59.9 years (range: 18-91). No statistically significant associations were found between VEGF expression and histological grade or subtype (P = 0.310). Conclusion Our findings suggest that VEGF is frequently present in meningiomas regardless of histological grade and should not be used as a marker of severity or histological grade.
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Affiliation(s)
- Rafael Contage Winter
- Departments of Neurosurgery Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Francine Hehn de Oliveira
- Departments of Neuropathology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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15
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Mirian C, Skyrman S, Bartek J, Jensen LR, Kihlström L, Förander P, Orrego A, Mathiesen T. The Ki-67 Proliferation Index as a Marker of Time to Recurrence in Intracranial Meningioma. Neurosurgery 2020; 87:1289-1298. [PMID: 32614441 DOI: 10.1093/neuros/nyaa226] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/27/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND There are examples of incongruence between the WHO grade and clinical course in meningioma patients. This incongruence between WHO grade and recurrence has led to search for other prognostic histological markers. OBJECTIVE To study the correlation between the Ki-67 proliferative index (PI), risk of recurrence, and recurrence rates in meningioma patients. METHODS We prospectively collected pathological diagnosis of de novo consecutive meningiomas. In total, we followed 159 patients with clinical controls until recurrence, death, or emigration. We estimated the correlation between risk of recurrence and Ki-67 PI when adjusted for age at diagnosis, sex, WHO grade, extent of surgical resection, and tumor location. We estimated the cumulative incidence of recurrence when considering death without recurrence a competing risk. We report recurrence rates per 100 person-years. RESULTS A 1%-point increase of Ki-67 PI yielded a hazard ratio of 1.12 (95% CI: 1.01-1.24) in a multivariate analysis. The cumulative incidence of recurrence was 3% for Ki-67 0% to 4% vs 19% for Ki-67 > 4% meningiomas after 1 yr, but 24% vs 35%, respectively, after 10 yr. There was no significant difference in mean Ki-67 PI between nonrecurrent and recurrent meningioma in a 2-sample t-test (P = .08). The strongest relationship was detected between Ki-67 PI and time to recurrence: Ki-67 < 4% meningiomas recurred after median 4.8 yr, compared to 0.60 to 0.75 yr for patients with higher Ki-67 PI. CONCLUSION Ki-67 PI was a marker for time to recurrence rather than a predictor of recurrence. Ki-67 PI may be utilized for patient tailored follow-up.
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Affiliation(s)
- Christian Mirian
- Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Simon Skyrman
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jiri Bartek
- Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lasse Rehné Jensen
- Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars Kihlström
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden
| | - Petter Förander
- Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Abiel Orrego
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Tiit Mathiesen
- Department of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Portet S, Banor T, Bousquet J, Simonneau A, Flores M, Ingrand P, Milin S, Karayan-Tapon L, Bataille B. New Insights into Expression of Hormonal Receptors by Meningiomas. World Neurosurg 2020; 140:e87-e96. [PMID: 32371078 DOI: 10.1016/j.wneu.2020.04.168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Meningiomas have a female predilection, which is even stronger for spinal than for intracranial meningiomas. The relationship between meningiomas and endogenous or exogenous sex hormones such as cyproterone acetate (CPA) is well documented, yet their underlying mechanism remains unknown. Clarification of the expression profile of hormonal receptors by meningiomas would help us to better understand their hormonal susceptibility. METHODS We used tissue microarray and immunohistochemistry to determine the receptor status of the 3 main sex hormones: androgen (AR), estrogen, and progesterone (PR) in 30 intracranial meningiomas, 30 spinal meningiomas, and 30 meningiomas developed on CPA. RESULTS AR status was positive in 73% of meningiomas in the intracranial group, 87% of meningiomas in the CPA group, and in all meningiomas in the spinal group. Estrogen status was positive in only 7% of meningiomas in the intracranial group and in only 3% of meningiomas in the CPA group but in 30% of meningiomas in the spinal group. PR status was positive in 90% of meningiomas in the intracranial group, in 97% of meningiomas in the CPA group, and in 87% of meningiomas in the spinal group. These specific hormonal receptor statuses based on immunoreactive score were reflected on staining intensities. Furthermore, AR and PR expression was correlated in each group. CONCLUSIONS Our study shows that intracranial meningiomas, spinal meningiomas, and meningiomas developed on CPA express specific hormonal receptor patterns. This result invites the scientific community to review the potential role of AR in the unbalanced sex ratio of meningiomas.
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Affiliation(s)
- Sylvain Portet
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France.
| | - Tania Banor
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
| | - Jonathan Bousquet
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
| | - Adrien Simonneau
- Department of Neurosurgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Marie Flores
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Pathology, University Hospital of Poitiers, Poitiers, France
| | - Pierre Ingrand
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Statistics, University Hospital of Poitiers, Poitiers, France
| | - Serge Milin
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Pathology, University Hospital of Poitiers, Poitiers, France
| | - Lucie Karayan-Tapon
- Faculty of Medicine, University of Poitiers, Poitiers, France; INSERM 1084, Experimental and Clinical Neurosciences Laboratory, University of Poitiers, Poitiers, France; Department of Cancer Biology, University Hospital of Poitiers, Poitiers, France
| | - Benoit Bataille
- Faculty of Medicine, University of Poitiers, Poitiers, France; Department of Neurosurgery, University Hospital of Poitiers, Poitiers, France
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17
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Graillon T, Cuny T, Castinetti F, Courbière B, Cousin M, Albarel F, Morange I, Bruder N, Brue T, Dufour H. Surgical indications for pituitary tumors during pregnancy: a literature review. Pituitary 2020; 23:189-199. [PMID: 31691893 DOI: 10.1007/s11102-019-01004-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Surgical indications for pituitary tumors during pregnancy are rare, and are derived from a balance between expected benefits, particularly for maternal benefits, and anesthetic/surgical risks. METHODS A literature review was performed to define the optimal surgical indications for pituitary adenomas (PA) and other pituitary tumors during pregnancy. RESULTS Main benefits are expected in case of critical visual impairment and/or life-threatening endocrine disturbances. Multidisciplinary patient management is systematically required although nonobstetric surgery presents a reasonable risk during pregnancy. The risks of congenital malformation during the first trimester and those of premature birth during the third trimester make the second trimester the optimal period for surgery. In prolactin-secreting, nonsecreting, GH- and TSH-secreting PAs, transsphenoidal surgery (TS) is recommended in cases involving severe visual impairment, characterized by severe visual field deficit, visual acuity impairment, and abnormal optical coherence tomography findings, and when no other medical alternatives are possible and/or sufficient. Uncontrolled and severe Cushing's disease (CD) during pregnancy increases both maternal and fetal morbimortality, thus justifying TS or sometimes dopamine agonist therapy as a safer alternative. Finally, metyrapone, ketoconazole, or bilateral adrenalectomy could be recommended in certain cases after the failure of medical therapies and/or TS. Surgery is also required for suprasellar meningiomas, craniopharyngiomas, and pituitary cysts in the case of severe visual deficit. CONCLUSION Surgical indications for pituitary tumors are rare during pregnancy; therefore, surgery should be avoided when possible. Further, the second trimester should be considered as the optimal surgical period. Severe visual disturbance and uncontrolled CD are the main surgical indications during pregnancy.
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Affiliation(s)
- Thomas Graillon
- Neurosurgery Department, Aix-Marseille Univ, APHM, CHU Timone, La Timone Hospital, 264 rue Saint-Pierre, 13005, Marseille, France.
- Aix-Marseille Univ, INSERM, MMG, Marseille, France.
| | - Thomas Cuny
- Aix-Marseille Univ, INSERM, MMG, Marseille, France
- Endocrinology Department, Aix-Marseille Univ, APHM, CHU Conception, Marseille, France
| | - Frédéric Castinetti
- Aix-Marseille Univ, INSERM, MMG, Marseille, France
- Endocrinology Department, Aix-Marseille Univ, APHM, CHU Conception, Marseille, France
| | - Blandine Courbière
- Centre Clinico-Biologique d'AMP, Pôle Femmes-Parents-Enfants, Hôpital de La Conception, AP-HM, Marseille/Aix Marseille Univ, Avignon Univ, CNRS, IRD, IBME, Marseille, France
| | - Marie Cousin
- Cabinet d'Ophtalmologie, Saint-Rémy de Provence, France
| | - Frédérique Albarel
- Endocrinology Department, Aix-Marseille Univ, APHM, CHU Conception, Marseille, France
| | - Isabelle Morange
- Endocrinology Department, Aix-Marseille Univ, APHM, CHU Conception, Marseille, France
| | - Nicolas Bruder
- Anesthesiology-Intensive Care Department, Aix-Marseille Univ, APHM, CHU Timone, Marseille, France
| | - Thierry Brue
- Aix-Marseille Univ, INSERM, MMG, Marseille, France
- Endocrinology Department, Aix-Marseille Univ, APHM, CHU Conception, Marseille, France
| | - Henry Dufour
- Neurosurgery Department, Aix-Marseille Univ, APHM, CHU Timone, La Timone Hospital, 264 rue Saint-Pierre, 13005, Marseille, France
- Aix-Marseille Univ, INSERM, MMG, Marseille, France
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18
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Partridge B, Rossmeisl JH. Companion animal models of neurological disease. J Neurosci Methods 2020; 331:108484. [PMID: 31733285 PMCID: PMC6942211 DOI: 10.1016/j.jneumeth.2019.108484] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 02/07/2023]
Abstract
Clinical translation of novel therapeutics that improve the survival and quality of life of patients with neurological disease remains a challenge, with many investigational drug and device candidates failing in advanced stage clinical trials. Naturally occurring inherited and acquired neurological diseases, such as epilepsy, inborn errors of metabolism, brain tumors, spinal cord injury, and stroke occur frequently in companion animals, and many of these share epidemiologic, pathophysiologic and clinical features with their human counterparts. As companion animals have a relatively abbreviated lifespan and genetic background, are immunocompetent, share their environment with human caregivers, and can be clinically managed using techniques and tools similar to those used in humans, they have tremendous potential for increasing the predictive value of preclinical drug and device studies. Here, we review comparative features of spontaneous neurological diseases in companion animals with an emphasis on neuroimaging methods and features, illustrate their historical use in translational studies, and discuss inherent limitations associated with each disease model. Integration of companion animals with naturally occurring disease into preclinical studies can complement and expand the knowledge gained from studies in other animal models, accelerate or improve the manner in which research is translated to the human clinic, and ultimately generate discoveries that will benefit the health of humans and animals.
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Affiliation(s)
- Brittanie Partridge
- Veterinary and Comparative Neuro-Oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, 24061, USA; Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Medical Center Blvd, NRC 405, Winston Salem, NC, 27157, USA
| | - John H Rossmeisl
- Veterinary and Comparative Neuro-Oncology Laboratory, Department of Small Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, 24061, USA; Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Medical Center Blvd, NRC 405, Winston Salem, NC, 27157, USA.
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19
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Stoyanov GS, Petkova L, Dzhenkov DL. A Practical Approach to the Differential Diagnosis of Intracranial Tumors: Gross, Histology, and Immunoprofile-based Algorithm. Cureus 2019; 11:e6384. [PMID: 31938662 PMCID: PMC6957037 DOI: 10.7759/cureus.6384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 12/15/2019] [Indexed: 12/22/2022] Open
Abstract
Intracranial tumors are a diverse group of conditions, both benign and malignant, primary and metastatic and always require detailed medical information, radiological reports and deep knowledge of the histological hallmarks and immunohistochemical profile of different types of tumors and tumor-like processes. Despite it clinically often being possible to differentiate between primary and metastatic tumors, based on the tumor location and age of the patient, histological variants and rare tumor entries should always be considered in the histological differential diagnosis. A thorough diagnostic algorithm based on the location of the tumor and its histological features, together with some common pitfalls in immunohistochemical profiling, based on the 2016 revised World Health Organization (WHO) classification of tumors of the central nervous system should be implemented in all cases. Such an algorithm is especially valuable in cases where only small tumor fragments are sent for morphological evaluation, such as in deep parenchyma tumors. In these instances where only small fragments of the tumor are present for histology, some key features, corresponding to the WHO grade, may easily be missed or underreported. Furthermore, the histological verification of the tumor entry is the first, often overlooked, step in defining the presence or absence of WHO grade-specific mutations.
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Affiliation(s)
- George S Stoyanov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Lilyana Petkova
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Deyan L Dzhenkov
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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20
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Maier AD, Bartek J, Eriksson F, Ugleholdt H, Juhler M, Broholm H, Mathiesen TI. Clinical and histopathological predictors of outcome in malignant meningioma. Neurosurg Rev 2019; 43:643-653. [DOI: 10.1007/s10143-019-01093-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/10/2019] [Accepted: 03/03/2019] [Indexed: 02/01/2023]
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21
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Shu X, Jiang Y, Wen T, Lu S, Yao L, Meng F. Association of hormone replacement therapy with increased risk of meningioma in women: A hospital-based multicenter study with propensity score matching. Asia Pac J Clin Oncol 2019; 15:e147-e153. [PMID: 30761745 DOI: 10.1111/ajco.13138] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 01/21/2019] [Indexed: 11/27/2022]
Abstract
AIM There is no consensus regarding the association between hormone replacement therapy (HRT) and risk of meningioma so far. We conducted the first study among Chinese female patients to investigate the influence of HRT use on the risk of meningioma. METHODS We retrospectively collected records of diagnosis of meningioma for women aged 50 years and above during 2011-2016 and dispense of HRT prior to meningioma diagnosis in three tertiary hospitals in China. Meningioma cases were matched with controls at a ratio of 1:2 by using nearest neighbor propensity scores matching in order to balance the baseline characteristics between groups, which generated a total of 629 cases with 1258 controls. RESULTS We observed prior use of HRT associated with increased risk of meningioma (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.0-1.4) and the association was more prominent among women having multiple HRT dispenses and longer term exposure (OR, 1.3; 95% CI, 1.1-1.6), among those with combination therapy of estrogens and progestogens (OR, 1.3; 95% CI, 1.1-1.7) than monotherapy, and among progestogen users than estrogen users as for monotherapy. Furthermore, vaginal, subcutaneous implant seems to be associated with a higher risk of meningioma compared with oral administration although no significance had been reached. CONCLUSION This case-control study provides evidence that hormone use for an HRT purpose might constitute the development and growth of meningioma as an independent risk factor, especially for combination therapy and/or long-term users, which supports that meningioma might be a hormone-sensitive tumor.
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Affiliation(s)
- Xiaochen Shu
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yun Jiang
- Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Tao Wen
- Medical Research Centre, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shun Lu
- Department of Radiation Oncology, Sichuan Cancer Hospital/Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - Lu Yao
- Department of Forth Cadre, General Hospital of Beijing Military Command of Chinese PLA, Beijing, China
| | - Fang Meng
- Centre of Systems Medicine, Chinese Academy of Medical Sciences, Beijing, China.,Suzhou Institute of Systems Medicine, Suzhou, China
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22
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Ülgen E, Bektaşoğlu PK, Sav MA, Can Ö, Danyeli AE, Hızal DB, Pamir MN, Özduman K. Meningiomas Display a Specific Immunoexpression Pattern in a Rostrocaudal Gradient: An Analysis of 366 Patients. World Neurosurg 2018; 123:e520-e535. [PMID: 30503291 DOI: 10.1016/j.wneu.2018.11.201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Meningiomas are heterogeneous, with differences in anatomical, histopathological, and clinical characteristics. Such spatial variability in meningioma biology is thought to result from differences in the expression of critical developmental regulators. We hypothesized that the variability in meningioma biology would follow gradients such as in embryology and tested a cohort of 366 meningiomas for histopathological and immunohistochemical gradients. METHODS The medical records from 366 patients treated for meningiomas from 2003 to 2016 were retrospectively analyzed for age, gender, anatomical localization, recurrence-free survival, overall survival, histopathological diagnosis, and immunohistochemistry findings for 6 markers: epithelial membrane antigen (EMA), progesterone receptor (PR), CD34, S100, p53, and Ki-67 labeling index. RESULTS EMA, PR, S100, p53, and CD34 were expressed in 94%, 73%, 49%, 26%, and 23% of the tumors, respectively. p53 expression correlated positively with Ki-67 and World Health Organization (WHO) grade (rτ = 0.31 and rτ = 0.4, respectively). PR positivity correlated inversely with S100, p53, Ki-67, and WHO grade (rτ = -0.19, rτ = -0.14, rτ = -0.15, and rτ = -0.16, respectively). All secretory meningiomas were positive for EMA and PR and negative for S100, and this pattern exhibited a rostrocaudal gradient. The overall proportion of EMA+PR+S100- cases was significantly lower in the cranial vault (30.3%) than in the skull base (45.89%; P = 0.021). The proportion of WHO grade II-III tumors was greater in cranial vault than in skull base meningiomas. CONCLUSIONS Unsupervised methods detected an association between the anatomical location and tumor biology in meningiomas. Unlike the categorical associations that former studies had indicated, the present study revealed a rostrocaudal gradient in both the cranial vault and the skull base, correlating with human developmental biology.
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Affiliation(s)
- Ege Ülgen
- Department of Biostatistics and Medical Informatics, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Pınar Kuru Bektaşoğlu
- Department of Neurosurgery, Turkish Ministry of Health, University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey; Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey
| | - M Aydın Sav
- Department of Pathology, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Özge Can
- Department of Medical Engineering, Faculty of Engineering, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Ayça Erşen Danyeli
- Department of Pathology, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Deniz Baycın Hızal
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland, USA; Biotechnology Department, Turgut Biopharmaceuticals, İstanbul, Turkey
| | - M Necmettin Pamir
- Department of Neurosurgery, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Koray Özduman
- Department of Neurosurgery, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
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Liu C, Yan L, Liu Q, Li J, Jin H, Wang J, Deng Y. Lumbar intraspinal microcystic/reticular schwannoma: Case report and literature review. Medicine (Baltimore) 2018; 97:e12474. [PMID: 30278533 PMCID: PMC6181603 DOI: 10.1097/md.0000000000012474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
RATIONALE Microcystic/reticular schwannoma (MRS) is a rare histological variant of schwannoma which was initially described in 2008 with a predilection for the visceral organs. This distinct tumor had been reported to mainly affect gastrointestinal tract, subcutaneous and soft tissue, various glands and head and neck region. However, MRS involving spine is extremely rare. PATIENT CONCERNS The authors report the first case of MRS occurring in the lumbar (L) spinal canal of a 40-year-old male who presented with continuous pain and numbness in both feet for 2.5 years. Physical examination revealed weakness of lower extremities and hyperalgesia of both feet. DIAGNOSES AND INTERVENTIONS The findings of pre-operative investigation were suspicious for either a schwannoma or a spinal meningioma. Accordingly, total laminectomy, complete tumor resection, instrumentation and spinal fusion were performed. Post-operative histopathologic examination revealed a well-encapsulated neoplasm with reticular and microcystic growth pattern. Antoni A and Antoni B regions, Verocay bodies and hyalinized blood vessels were observed. And cytologic atypia, necrosis or mitosis was absent. Immunohistochemically, the tumor cells showed strong and diffuse positivity for S-100 as well as SOX 10. Therefore, a histopathological diagnosis of MRS was finally made. OUTCOMES The patient remains well with no evidence of recurrence at a 22-month follow-up. LESSONS This is the first case of MRS which is located in the L spinal canal. Awareness of this distinctive entity is helpful in preventing diagnostic pitfalls and making correct treatment strategies.
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Affiliation(s)
- Congcong Liu
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan
| | - Lianqi Yan
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan
- Department of Orthopedics, Clinical medical college of Yangzhou University
- Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu
| | - Qing Liu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan
| | - Jing Li
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan
| | - Hongtao Jin
- Department of Pathology, Shen Zhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen, Guangdong
| | - Jingcheng Wang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan
- Department of Orthopedics, Clinical medical college of Yangzhou University
- Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu
| | - Youwen Deng
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan
- Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Kuroi Y, Matsumoto K, Shibuya M, Kasuya H. Progesterone Receptor Is Responsible for Benign Biology of Skull Base Meningioma. World Neurosurg 2018; 118:e918-e924. [PMID: 30031954 DOI: 10.1016/j.wneu.2018.07.100] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Many studies have been performed to evaluate the roles of estrogen receptor and progesterone receptor (PGR) in meningiomas, but their influence on tumor behavior remains unclear. METHODS We retrospectively analyzed patients with meningioma who underwent surgical resection at our institute. Patients with data for immunohistochemical staining of estrogen receptor, PGR, and Ki-67 were included. RESULTS The study included 161 patients comprising 61 skull base and 100 non-skull base meningiomas. Histologically, the number of patients with World Health Organization (WHO) grade I, II, and III disease were 132 (82.0%), 22 (14.7%), and 7 (4.4%), respectively. Tumor recurrence was observed in 21 (13.0%). Negative PGR, high Ki-67 index, incomplete resection, and WHO grade II or III were significantly correlated with tumor recurrence and shorter recurrence-free survival. Skull base meningiomas were difficult to remove entirely; 31 patients (50.8%) with skull base and 77 patients (77.0%) with non-skull base meningiomas had overall complete removal (P = 0.0006). Ki-67 indices, proportion of WHO grade II or III, and recurrence rate or recurrence-free survival did not differ between the tumor locations. The only difference was the proportion of patients with positive PGR, which was significantly higher for skull base meningiomas (61.5 ± 33.4% vs. 42.2 ± 35.7%, P = 0.0009). CONCLUSIONS Although skull base meningiomas are often incompletely resected, there were no differences in recurrence-free survival or recurrence rate between skull base and non-skull base meningiomas. As the Ki-67 index and WHO grade were not different between these locations, the high rate of positive PGR may be responsible for the benign biology of skull base meningiomas.
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Affiliation(s)
- Yasuhiro Kuroi
- Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
| | - Kasumi Matsumoto
- School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Makoto Shibuya
- Central Laboratory, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Hidetoshi Kasuya
- Department of Neurosurgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
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Zhang XP, Jiang GY, Zhang QF, Xu HT, Li QC, Wang EH. Primary acinic cell carcinoma of the lung with psammoma bodies: A case report and review of literature. Pathol Res Pract 2017; 213:405-409. [DOI: 10.1016/j.prp.2017.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/14/2017] [Accepted: 01/14/2017] [Indexed: 02/06/2023]
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26
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Arnli MB, Backer-Grøndahl T, Ytterhus B, Granli US, Lydersen S, Gulati S, Torp SH. Expression and clinical value of EGFR in human meningiomas. PeerJ 2017; 5:e3140. [PMID: 28367377 PMCID: PMC5374971 DOI: 10.7717/peerj.3140] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/02/2017] [Indexed: 01/08/2023] Open
Abstract
Background Meningiomas are common intracranial tumors in humans that frequently recur despite having a predominantly benign nature. Even though these tumors have been shown to commonly express EGFR/c-erbB1 (epidermal growth factor receptor), results from previous studies are uncertain regarding the expression of either intracellular or extracellular domains, cellular localization, activation state, relations to malignancy grade, and prognosis. Aims This study was designed to investigate the expression of the intracellular and extracellular domains of EGFR and of the activated receptor as well as its ligands EGF and TGFα in a large series of meningiomas with long follow-up data, and investigate if there exists an association between antibody expression and clinical and histological data. Methods A series of 186 meningiomas consecutively operated within a 10-year period was included. Tissue microarrays were constructed and immunohistochemically analyzed with antibodies targeting intracellular and extracellular domains of EGFR, phosphorylated receptor, and EGF and TGFα. Expression levels were recorded as a staining index (SI). Results Positive immunoreactivity was observed for all antibodies in most cases. There was in general high SIs for the intracellular domain of EGFR, phosphorylated EGFR, EGF, and TGFα but lower for the extracellular domain. Normal meninges were negative for all antibodies. Higher SIs for the phosphorylated EGFR were observed in grade II tumors compared with grade I (p = 0.018). Survival or recurrence was significantly decreased in the time to recurrence analysis (TTR) with high SI-scores of the extracellular domain in a univariable survival analysis (HR 1.152, CI (1.036–1.280, p = 0.009)). This was not significant in a multivariable analysis. Expression of the other antigens did not affect survival. Conclusion EGFR is overexpressed and in an activated state in human meningiomas. High levels of ligands also support this growth factor receptor system to be involved in meningioma tumorigenesis. EGFR may be a potential candidate for targeted therapy.
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Affiliation(s)
- Magnus B Arnli
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Thomas Backer-Grøndahl
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Borgny Ytterhus
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Unn S Granli
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Cellular and Molecular Imaging Core Facility (CMIC), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
| | - Sasha Gulati
- Department of Neurosurgery, St. Olavs Hospital , Trondheim , Norway
| | - Sverre H Torp
- Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Pathology, St. Olavs Hospital, Trondheim, Norway
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27
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Elmaci İ, Altinoz MA, Sav A, Yazici Z, Ozpinar A. Giving another chance to mifepristone in pharmacotherapy for aggressive meningiomas—A likely synergism with hydroxyurea? Curr Probl Cancer 2016; 40:229-243. [DOI: 10.1016/j.currproblcancer.2016.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/10/2016] [Accepted: 05/02/2016] [Indexed: 12/31/2022]
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28
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Fernandez C, Nicholas MK, Engelhard HH, Slavin KV, Koshy M. An analysis of prognostic factors associated with recurrence in the treatment of atypical meningiomas. Adv Radiat Oncol 2016; 1:89-93. [PMID: 28740874 PMCID: PMC5506715 DOI: 10.1016/j.adro.2016.03.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 01/13/2016] [Accepted: 03/02/2016] [Indexed: 11/25/2022] Open
Abstract
Background There has been increased reporting of atypical meningioma (grade II) since the World Health Organization reclassification in 2000, and the use of postoperative radiation therapy (RT) in the treatment of these tumors is controversial. We evaluated patients treated at our institution to identify patient subgroups with increased risk of recurrence that may benefit from adjuvant RT. Methods and materials We retrospectively assessed 50 patients treated for World Health Organization grade II meningiomas between March 2000 and February 2013. Sex, race, age of diagnosis, tumor location, performance status, size of tumor, MIB-1 index, resection status, and RT were recorded. Patient follow-up, recurrence, and vital status were measured to assess 3-year overall survival (OS) and recurrence free survival (RFS). Results The median follow-up was 37 months (range, 1-148). Female sex was associated with decreased RFS compared with male sex (86.1% vs 100%, P = .047). Subtotal resection demonstrated both inferior RFS (67.5% vs 96.6%, P = .025) and OS compared with gross total resection (70.0% vs 100%, P < .001). Tumors >4.5 cm had worse RFS than tumors ≤4.5 cm (85.4% vs 100%, P = .025). Patient OS was lower in tumors with an MIB-1 index >5% than ≤5% (89.7% vs 100%, P = .008). Eastern Cooperative Oncology Group 2-4 negatively impacted OS relative to patients with an Eastern Cooperative Oncology Group 0-1 (66.7% vs 100%, P < .001). Conclusions Significantly higher rates of recurrence occurred in female sex, subtotal resection, and tumors larger than 4.5 cm. Further studies are needed to confirm these findings and determine whether patients without any of these risk factors can undergo surgical resection without adjuvant radiation therapy.
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Affiliation(s)
- Christian Fernandez
- Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois.,Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois
| | - Martin K Nicholas
- Department of Neurology, University of Illinois at Chicago, Chicago, Illinois
| | - Herbert H Engelhard
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois
| | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois
| | - Matthew Koshy
- Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois.,Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois
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Rutkowski R, Reszec J, Hermanowicz A, Chrzanowski R, Lyson T, Mariak Z, Chyczewski L. Correlation of leptin receptor expression with BMI in differential grades of human meningiomas. Oncol Lett 2016; 11:2515-2519. [PMID: 27073509 DOI: 10.3892/ol.2016.4272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 12/17/2015] [Indexed: 12/25/2022] Open
Abstract
Meningioma is one of the most common primary brain tumor, especially in postmenopausal women. The most important risk factors include radiation, primary head injury or genetic alterations, however it is currently unclear why postmenopausal women are predominantly affected. The aim of the present study was to evaluate leptin receptor (LEPR) expression and body mass index (BMI) in patients with meningiomas of differential grades. Specimens of 158 meningiomas were classified as either G1 (low-grade meningiomas, n=114) or G2/G3 (high-grade meningiomas, n=44). Immunohistochemistry was performed to assess LEPR expression. The mean BMIs of the female and male patient groups were 28.43±5.29 and 23.93±4.66, respectively. Mean BMI was significantly higher in the female group, by ~4.50 kg/m2. Patient age significantly correlated with LEPR expression, with the highly positive (++) and positive (+) groups having mean ages of 62.3±12.07 and 52.3±13.04, respectively. A strong positive correlation (r=0.73) was observed between leptin receptor expression and BMI, with the LEPR (++) group having a mean BMI of 30.11±4.49, compared to 22.12±2.48 for the LEPR (+) group. Furthermore, in the low-grade meningioma group, mean BMI was higher in female patients than male patients (28.13±5.54 and 25.38±4.57, respectively; P=0.01). Additionally, there was strong positive correlation between BMI and leptin receptor expression in the low-grade meningioma group (r=0.69). For the high-grade meningioma group, mean BMI was 29.49±4.26 and 21.76±3.98 in female and male patients, respectively, and LEPR expression strongly correlated with BMI in this group (r=0.80). The present study demonstrates a correlation between patient BMI, age, and LEPR expression status in low- and high-grade meningiomas. Our results indicate that in addition to endogenous hormones, such as estrogen or progesterone, or fatty tissue-associated proinflammatory cytokines, LEPR expression status may be a risk factor for meningioma growth and progression.
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Affiliation(s)
- Robert Rutkowski
- Department of Neurosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Joanna Reszec
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Adam Hermanowicz
- Department of Neurosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Robert Chrzanowski
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Tomasz Lyson
- Department of Neurosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Zenon Mariak
- Department of Neurosurgery, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Lech Chyczewski
- Department of Medical Pathomorphology, Medical University of Bialystok, 15-276 Bialystok, Poland
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Birth Size Characteristics and Risk of Brain Tumors in Early Adulthood: Results from a Swedish Cohort Study. Cancer Epidemiol Biomarkers Prev 2016; 25:678-85. [DOI: 10.1158/1055-9965.epi-15-1096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/13/2016] [Indexed: 11/16/2022] Open
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Hilton DA, Shivane A, Kirk L, Bassiri K, Enki DG, Hanemann CO. Activation of multiple growth factor signalling pathways is frequent in meningiomas. Neuropathology 2015; 36:250-61. [DOI: 10.1111/neup.12266] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/25/2015] [Accepted: 09/26/2015] [Indexed: 01/14/2023]
Affiliation(s)
- David A Hilton
- Department of Cellular and Anatomical Pathology; Derriford Hospital; Plymouth UK
| | - Aditya Shivane
- Department of Cellular and Anatomical Pathology; Derriford Hospital; Plymouth UK
| | - Leanne Kirk
- Department of Cellular and Anatomical Pathology; Derriford Hospital; Plymouth UK
| | - Kayleigh Bassiri
- Institute of Translational and Stratified Medicine; Plymouth University Peninsula Schools of Medicine & Dentistry; Plymouth UK
| | - Doyo G Enki
- Plymouth University Peninsula Schools of Medicine & Dentistry; Plymouth UK
| | - C Oliver Hanemann
- Institute of Translational and Stratified Medicine; Plymouth University Peninsula Schools of Medicine & Dentistry; Plymouth UK
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Cossu G, Levivier M, Daniel RT, Messerer M. The Role of Mifepristone in Meningiomas Management: A Systematic Review of the Literature. BIOMED RESEARCH INTERNATIONAL 2015; 2015:267831. [PMID: 26146614 PMCID: PMC4469754 DOI: 10.1155/2015/267831] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/27/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVES We performed a systematic literature review to analyze the clinical application and the safety of mifepristone, a prominent antiprogesterone agent, in meningioma patients. MATERIALS AND METHODS A systematic search was performed through Medline, Cochrane, and clinicaltrials.gov databases from 1960 to 2014. Study Selection. Studies were selected through a PICO approach. Population was meningioma patients, meningioma cells cultures, and animal models. Intervention was mifepristone administration. Control was placebo administration or any other drug tested. Outcomes were clinical and radiological responsiveness, safety profile, and cell growth inhibition. RESULTS A total of 7 preclinical and 6 clinical studies and one abstract were included. Encouraging results were found in preclinical studies. Concerning clinical studies, the response rate to mifepristone in terms of radiological regression and symptomatic improvement/stability in patients with inoperable meningioma was low. In meningiomatosis, favorable preliminary results were recorded. The safety profile was good. Limitations were as follows. The tumoral expression of progesterone receptors was not analyzed systematically in every study considered. CONCLUSIONS No clear evidence exists to recommend mifepristone in inoperable meningiomas. Preliminary encouraging results were found in diffuse meningiomatosis. Mifepristone is a well-tolerated treatment. Patients' selection and hormonal profile analysis in meningiomas are fundamental for a better understanding of its benefit. Multicenter placebo-controlled trials are required.
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Affiliation(s)
- Giulia Cossu
- Service of Neurosurgery, Department of Clinical Neuroscience, Faculty of Human Medicine and Biology, University Hospital of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Marc Levivier
- Service of Neurosurgery, Department of Clinical Neuroscience, Faculty of Human Medicine and Biology, University Hospital of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Roy Thomas Daniel
- Service of Neurosurgery, Department of Clinical Neuroscience, Faculty of Human Medicine and Biology, University Hospital of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Mahmoud Messerer
- Service of Neurosurgery, Department of Clinical Neuroscience, Faculty of Human Medicine and Biology, University Hospital of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
- Department of Neurosurgery, University Hospital of Bicetre, Faculty of Medicine of Paris Sud, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
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Hicks J, Platt S, Kent M, Haley A. Canine brain tumours: a model for the human disease? Vet Comp Oncol 2015; 15:252-272. [PMID: 25988678 DOI: 10.1111/vco.12152] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 04/04/2015] [Accepted: 04/06/2015] [Indexed: 01/10/2023]
Abstract
Canine brain tumours are becoming established as naturally occurring models of disease to advance diagnostic and therapeutic understanding successfully. The size and structure of the dog's brain, histopathology and molecular characteristics of canine brain tumours, as well as the presence of an intact immune system, all support the potential success of this model. The limited success of current therapeutic regimens such as surgery and radiation for dogs with intracranial tumours means that there can be tremendous mutual benefit from collaboration with our human counterparts resulting in the development of new treatments. The similarities and differences between the canine and human diseases are described in this article, emphasizing both the importance and limitations of canines in brain tumour research. Recent clinical veterinary therapeutic trials are also described to demonstrate the areas of research in which canines have already been utilized and to highlight the important potential benefits of translational research to companion dogs.
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Affiliation(s)
- J Hicks
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - S Platt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - M Kent
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - A Haley
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Liu M, Zhang K, Zhao Y, Guo Q, Guo D, Zhang J. Evidence for involvement of steroid receptors and coactivators in neuroepithelial and meningothelial tumors. Tumour Biol 2014; 36:3251-61. [PMID: 25534237 DOI: 10.1007/s13277-014-2954-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 12/04/2014] [Indexed: 11/25/2022] Open
Abstract
Steroid receptors such as androgen receptor (AR) and estrogen receptors (ER) ER-α and ER-β, and their receptor coactivators (steroid receptor coactivator, SRC) are widely localized in the brain. Although previous studies have investigated the expression of steroid receptors in brain tumors like astrocytoma, the studies on the expression of steroid receptors and SRCs in other brain tumors are lacking. Here, we investigated the expression of AR, ERs, and SRCs in neuroepithelial (medulloblastoma, ependymoma, oligodendroglioma) and meningothelial meningioma using tissue microarray immunohistochemistry. Compared to normal brain tissue, we found that the expression of SRC-1, SRC-3, and ER-α significantly decreased in meningothelial tumor and neuroepithelial tumor, suggesting that the SRC-1/SRC-3 levels may be regulated by ER-α. Moreover, the levels of AR strongly correlated to the levels of ER-β. Furthermore, correlation was also detected between SRC-3 and AR in neuroepithelial tumor, and between ER-α and ER-β in meningothelial tumor. In addition, the decreased ratio of SRC-1/SRC-3 was associated with an increase of ER-β in neuroepithelial tumor. These results indicate that expressions of different steroid receptors and activators may be tumor type dependent. While AR, ER-α, and ER-β may be involved in the pathogenesis of meningothelial tumor, SRCs/ER-β axis and SRC-3/AR axis may play a role in the pathogenesis of neuroepithelial tumor.
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Affiliation(s)
- Mengying Liu
- Department of Neurobiology, Chongqing Key Laboratory of Neurobiology, Third Military Medical University, Chongqing, 400038, China
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SHIBUYA M. Pathology and molecular genetics of meningioma: recent advances. Neurol Med Chir (Tokyo) 2014; 55:14-27. [PMID: 25744347 PMCID: PMC4533397 DOI: 10.2176/nmc.ra.2014-0233] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/21/2014] [Indexed: 01/16/2023] Open
Abstract
Meningiomas are the most common intracranial primary neoplasm in adults. Although the spectrum of clinical and molecular genetic issues regarding meningiomas remains undefined, novel genetic alterations that are associated with tumor morphology, malignancy, or location have recently been discovered. This review focuses on recent advances in understanding of the heterogenous pathology of meningiomas, particularly on associations between the clinical, histological, etiological, epidemiological, and molecular genetical aspects of the neoplasm.
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Affiliation(s)
- Makoto SHIBUYA
- Central Laboratory, Hachioji Medical Center, Tokyo Medical University, Tokyo
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36
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Successful treatment of multiple intracranial meningiomas with the antiprogesterone receptor agent mifepristone (RU486). Acta Neurochir (Wien) 2014; 156:1831-5. [PMID: 25078073 DOI: 10.1007/s00701-014-2188-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/15/2014] [Indexed: 01/31/2023]
Abstract
BACKGROUND Meningiomas are the most frequent primary brain tumor in adults. Evidence suggests that female sex hormones play a role in the meningioma tumorigenesis. In particular, progesterone, has a receptor (PR) that is highly expressed in the majority of grade I meningiomas. Multiple meningiomas (diffuse meningiomatosis) are less frequent, but have a higher female predominance and a higher PR expression. They are, therefore, attractive candidates for anti-PR therapy. METHODS We treated three consecutive women with multiple meningiomas with mifepristone (RU 486). It is a synthetic steroid with high affinity for both progesterone and glucocorticoid receptors. RESULTS The treatment was well tolerated, and we observed an important and long-lasting clinical (3/3) and radiological response (2/3) or stabilisation. All the three patients are now stable after five to nine years of treatment. CONCLUSIONS These encouraging results strongly support a prospective clinical trial in this preselected population.
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