Reactions 1704, p127 - 2 Jun 2018
Intracranial meningioma: case report
A 41-year-old transwoman (male-to-female transsexual)
developed intracranial meningioma following treatment with
cyproterone [cyproterone acetate] and estradiol.
The patient, who was receiving hormone suppression
treatment with cyproterone 50mg per day [route not stated]
and estradiol gel 1mg and thereafter 2mg and up to 3mg per
day for the last nine years, presented with partial inability to
read and some prosopagnosia episodes for one year. The
patient’s medical history included ganglioglioma diagnosed
four years earlier and subsequent partial tumour resection.
Upon current presentation, an MRI scan revealed a 3cm left
Cyproterone was withdrawn and it was substituted with
leuprorelin [leuprorelina acetate], which was given in
combination with transdermal estradiol. The patient
underwent a second surgery for radical tumour resection.
Histological examination revealed meningothelial meningioma
(WHO, grade I). The meningioma was found to be strongly
progesterone receptor-positive and slightly estrogen receptor-
positive, with an MIB-1 index of 1%. The patient continued
receiving treatment with leuprorelin and estradiol. One year
later, a follow up MRI revealed no recurrence of the tumour.
Author comment: "We report the ninth known case of
growth of intracranial meningioma in a transwoman who had
been taking feminizing hormones consisting of estradiol and
cyproterone for the previous nine years. At histological
examination, the meningioma resulted in high positivity
(90%) for progestin receptors with low positivity for estrogen
receptors (20%) thereby confirming the hypothesis of a link
between meningioma and sex steroids."
Mancini I, et al. Presentation of a meningioma in a transwoman after nine years of
cyproterone acetate and estradiol intake: case report and literature review.
Gynecological Endocrinology 34: 456-459, No. 6, Jun 2018. Available from: URL:
http://doi.org/10.1080/09513590.2017.1395839 - Italy
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved