Acute progression of recurrent meningioma during luteinizing hormone-releasing hormone agonist treatment for prostate cancer

BACKGROUND - Meningiomas are the most common type of benign brain tumor and the incidence of meningioma in women is more than two-fold higher than in men. Several studies have demonstrated that hormones were somehow related to the growth of meningiomas.

CASE DESCRIPTION - A 72-year-old man with benign meningioma underwent tumor resection and had no recurrence for 18 years. He was found to have prostate cancer and received hormonal therapy with a luteinizing hormone-releasing hormone (LHRH) agonist. Two years later, he developed severe cognitive dysfunction and gait disturbance. Gadolinium-enhanced brain magnetic resonance imaging revealed a large recurrent mass and obstructive hydrocephalus. Staged resection was performed and stereotactic radiation therapy was administered against the residual tumor. His symptoms improved after endoscopic third ventriculostomy for obstructive hydrocephalus and his residual tumor remains stable.

CONCLUSIONS - This is the first report of a case wherein an LHRH agonist promoted the growth of a pre-existing meningioma. We suggest that patients with a history of meningioma who are receiving LHRH agonist treatment should be closely monitored.

World neurosurgery. 2016 Mar 30 [Epub ahead of print]

Taishi Tsutsui, Katsuyoshi Miyashita, Hemragul Sabit, Issei Fukui, Yasuhiko Hayashi, Atsushi Mizokami, Hiroko Ikeda, Hitoshi Nagatani, Mitsutoshi Nakada

Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan., Department of Pathology, Kanazawa University Hospital, Ishikawa, Japan., Department of Neurosurgery, Oumikusatsu Tokushukai Hospital, Shiga, Japan., Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan.