Regression of Intracranial Meningioma during Treatment with α1-Adrenoceptor Blocker

Spontaneous regression of a posterior fossa meningioma: A case report

Background:

Since most incidentally discovered meningiomas grow or remain unchanged, spontaneous regression is extremely rare. Here, we report a case of posterior fossa meningioma showing spontaneous regression.

Case Description:

A 55-year-old female was referred to our hospital because she was diagnosed with a left posterior fossa meningioma (diameter: 1.6 cm) during a brain check-up. The patient was followed up on periodic magnetic resonance imaging studies. Tumor size remained almost unchanged for 2 years but then began to regress. Twelve years after the initial examination, the tumor diameter idiopathically decreased from 1.6 cm to 1.1 cm while the tumor volume decreased from 2.3 cm³ to 0.5 cm³ (about 1/4^th the original size). Postmenopausal hormonal imbalances may have been associated with the observed spontaneous regression.

Conclusion:

Understanding the natural history of meningiomas is essential for a better selection of treatment approaches or appropriate follow-up. This case may provide new insights into the progression of meningiomas.

Spontaneus involution of meningioma. Case report and literature review

Meningiomas are tumors of the cerebral meninges, with slow growth and usually benign, whose treatment is essentially surgery. They have progesterone receptors, and to a lesser extent estrogen, which sometimes causes them to have growth or involution linked to hormonal treatment. Its spontaneous involution is extremely rare. We present the case of a male with a meningioma of the sphenoid planum. He had a history of diabetes mellitus, myasthenia gravis and prostate cancer. He was in treatment with analogs of GnRH (leuprorelin), antiandrogen (bicalutamide), β3 agonists and α1 blockers. 15 months after the hormonal blockade, a reduction of the tumor of approximately 90% of its volume was detected. Previous reports show that treatment with gonadotropin analogues produces growth in some meningiomas. Other reports of spontaneous involution affect diabetic patients and patients in treatment with α1 blockers. Literature focus on meningiomas with spontaneous involution is reviewed.