Acta Neurochirurgica

, Volume 80, Issue 1–2, pp 35–41 | Cite as

Hormone treatment of meningiomas: Lack of response to medroxyprogesterone acetate (MPA)

A pilot study of five cases
  • J. Jääskeläinen
  • E. Laasonen
  • J. Kärkkäinen
  • M. Haltia
  • H. Troupp
Clinical Research


Medroxyprogesterone acetate (MPA) has been used in high doses as hormone treatment for metastatic breast cancer. We treated five intracranial meningiomas with MPA expecting that MPA would reduce the volume or decrease the growth rate. All five patients were postmenopausal women, aged 47 to 73 years. Before treatment, the growth rate of each tumour was assessed by two consecutive CT scans (CT 1 and CT 2). Tumours 1 to 4, histologically benign meningiomas, grew slowly as the tumour volumes were not found to increase in 21 to 45 months between CT 1 and CT 2. Tumour 5 was an anaplastic meningioma the rapid growth of which was evident in 8 weeks between CT 1 and CT 2. After CT 2, MPA was given 1,000 mg intramusculary once weekly for 17 to 29 weeks until CT 3 which showed the response. Tumours 1 to 4 had neither reduced in volume nor developed necroses, and tumour 5 continued its fast growth at the same rate as before.


Meningioma medroxyprogesterone acetate hormone treatment growth rate CT scan 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Barrow, D. L., Tindall, G. T., Kovacs, K., Thorner, M. O., Horvath, E., Hoffman, J. C., Jr., Clinical and pathological effects of bromocriptine on prolactin-secreting and other pituitary tumors. J. Neurosurg.60 (1984), 1–7.PubMedGoogle Scholar
  2. 2.
    Blankenstein, M. A., Blaauw, G., Lamberts, W. J., Mulder, E., Presence of progesterone receptors and absence of oestrogen receptors in human intracranial meningioma cytosols. Eur. J. Cancer. Clin. Oncol.19 (1983), 365–370.PubMedGoogle Scholar
  3. 3.
    Breiman, R. S., Beck, J. W., Korobkin, M., Glenny, R., Akwari, O. E., Heaston, D. K., Moore, A. V., Ram, P. V. C., Volume determinations using computed tomography. AJR138 (1982), 329–333.PubMedGoogle Scholar
  4. 4.
    Cahill, D. W., Bashirelahi, N., Solomon, L. W., Dalton, T., Salcman, M., Ducker, T. B., Estrogen and progesterone receptors in meningiomas. J. Neurosurg.60 (1984), 985–993.PubMedGoogle Scholar
  5. 5.
    Carella, R. J., Ransohoff, J., Newall, J., Role of radiation therapy in the management of meningioma. Neurosurgery10 (1982), 332–339.PubMedGoogle Scholar
  6. 6.
    Dethlefsen, L. A., Prewitt, J. M. S., Mendelsohn, M. L., Analysis of tumor growth curves. J. Nat. Cancer Inst.40 (1968), 389–405.PubMedGoogle Scholar
  7. 7.
    Donnell, M. S., Meyer, G. A., Donegan, W., Estrogen-receptor protein in intracranial meningiomas. J. Neurosurg.50 (1979), 499–502.PubMedGoogle Scholar
  8. 8.
    Glick, R. P., Molteni, A., Fors, E. M., Hormone binding in brain tumors. Neurosurgery13 (1983), 513–519.PubMedGoogle Scholar
  9. 9.
    Henderson, C., Canellos, G. P., Cancer of the breast. The past decade. N. Engl. J. Med.302 (1980), 17–30, 78–90.PubMedGoogle Scholar
  10. 10.
    Hinton, D., Mobbs, E. G., Sima, A. A., Hanna, W., Steroid receptors in meningiomas. A histochemical and biochemical study. Acta Neuropathol. (Berl.)62 (1983), 134–140.Google Scholar
  11. 11.
    Horwitz, K. B., Koseki, Y., McGuire, W. L., Estrogen control of progesterone receptor in human breast cancer: role of estradiol and antiestrogen. Endocrinology103 (1978), 1742–1751.PubMedGoogle Scholar
  12. 12.
    Inoue, H., Tamamura, M., Koizumi, H., Nakamura, M., Naganuma, H., Ohye, C., Clinical pathology of malignant meningiomas. Acta Neurochir. (Wien)73 (1984), 179–191.Google Scholar
  13. 13.
    Jellinger, K., Slowik, F., Histological subtypes and prognostic problems in meningiomas. J. Neurol.208 (1975), 279–298.PubMedGoogle Scholar
  14. 14.
    Johnson, J. R., Priestman, T. J., Fotherby, K., Kelly, K. A., Priestman, S. G., An evaluation of high-dose medroxyprogesterone acetate (MPA) therapy in women with advanced breast cancer. Brit. J. Cancer50 (1984), 363–366.PubMedGoogle Scholar
  15. 15.
    Jääskeläinen, J., Haltia, M., Laasonen, E., Wahlström, T., Valtonen, S., The growth rate of intracranial meningiomas and its relation to histology: an analysis of 43 patients. Surg. Neurol.24 (1985), 165–172.PubMedGoogle Scholar
  16. 16.
    Lusins, J. O., Nagakawa, H., Multiple meningiomas evaluated by computed tomography. Neurosurgery9 (1981), 137–141.PubMedGoogle Scholar
  17. 17.
    Magdelenat, H., Pertuiset, B. F., Poisson, M., Martin, P. M., Philippon, J., Pertuiset, B., Buge, A., Progestin and oestrogen receptors in meningiomas. Biochemical characterization, clinical and pathological correlations in 42 cases. Acta Neurochir. (Wien)64 (1982), 199–213.Google Scholar
  18. 18.
    Markwalder, T.-M., Zava, D. T., Goldhirsch, A., Markwalder, R. V., Estrogen and progesterone receptors in meningiomas in relation to clinical and pathological features. Surg. Neurol.20 (1983), 42–47.PubMedGoogle Scholar
  19. 19.
    Markwalder, T.-M., Seiler, R. W., Zava, D. T., Endocrine manipulation of inoperable and recurrent meningiomas—a pilot study. In: Proceedings of the 13th International Congress of Chemotherapy (Spitzyet al., eds.). Vienna: Verlag H. Egermann. 1983.Google Scholar
  20. 20.
    Martin, F., Adlercreutz, H., Aspects of megestrol acetate and medroxyprogesterone acetate metabolism. In: Pharmacology of Steroid Contraceptive Drugs (Garattiniet al., eds.), pp. 99–115. New York: Raven Press. 1977.Google Scholar
  21. 21.
    Martuza, R. L., MacLaughlin, D. T., Ojemann, R. G., Specific estradiol binding in schwannomas, meningiomas and neurofibromas. Neurosurgery9 (1981), 665–671.PubMedGoogle Scholar
  22. 22.
    Martuza, R. L., Miller, D. C., MacLaughlin, D. T., Estrogen and progestin binding by cytosolic and nuclear fractions of human meningiomas. J. Neurosurg.62 (1985), 750–756.PubMedGoogle Scholar
  23. 23.
    Mattsson, W., High dose medroxyprogesterone-acetate treatment in advanced mammary carcinoma. A phase II investigation. Acta Radiol. Oncol.17 (1978), 387–400.Google Scholar
  24. 24.
    Meyer, J. S., Growth and cell kinetic measurements in human tumors. Pathol. Annu.16 (1981), 53–81.PubMedGoogle Scholar
  25. 25.
    Mirimanoff, R. O., Dosoretz, D. E., Ojemann, R. G., Martuza, R. L., Meningioma: analysis of recurrence and progression following neurosurgical resection. J. Neurosurg.62 (1985), 18–24.PubMedGoogle Scholar
  26. 26.
    Osborne, C. K., Yochmowitz, M. G., Knight, W. A., III, McGuire, W. L., The value of estrogen and progesterone receptors in the treatment of breast cancer. Cancer46 (1980), 2884–2888.PubMedGoogle Scholar
  27. 27.
    Pannuti, F., Martoni, A., Lenaz, G. R., Piana, E., Nanni, P., A possible new approach to the treatment of metastatic breast cancer: Massive doses of medroxyprogesterone acetate. Cancer Treat. Rep.62 (1978), 499–504.PubMedGoogle Scholar
  28. 28.
    Pannuti, F., Martoni, A., DiMarco, A. R.,et al., Prospective, randomized clinical trial of two different high dosages of medroxyprogesterone acetate (MAP) in the treatment of metastatic breast cancer. Europ. J. Cancer15 (1979), 593–601.Google Scholar
  29. 29.
    Pertuiset, B., Farah, S., Clayes, L., Goutorbe, J., Metzger, J., Kujas, M., Operability of intracranial meningiomas. Personal series of 353 cases. Acta Neurochir. (Wien)76 (1985), 2–11.Google Scholar
  30. 30.
    Schnegg, J.-F., Gomez, F., LeMarchand-Beraud, T., de Tribolet, N., Presence of sex steroid hormone receptors in meningioma tissue. Surg. Neurol.15 (1981), 415–418.PubMedGoogle Scholar
  31. 31.
    Schoenberg, B. S., Christine, B. W., Whisnant, J. P., Nervous system neoplasms and primary malignancies of other sites: the unique association between breast cancer and meningiomas. Neurology25 (1975), 705–712.PubMedGoogle Scholar
  32. 32.
    Schwartz, M. R., Randolph, R. L., Cech, D. A., Rose, J. E., Panko, W. B., Steroid hormone binding macromolecules in meningiomas. Failure to meet criteria of specific receptors. Cancer53 (1984), 922–927.PubMedGoogle Scholar
  33. 33.
    Simpson, D., The recurrence of intracranial meningiomas after surgical treatment. J. Neurol. Neurosurg. Psychiatry20 (1957), 22–39.Google Scholar
  34. 34.
    Steel, G. G., Lamerton, L. F., The growth rate of human tumors. Brit. J. Cancer20 (1966), 74–86.PubMedGoogle Scholar
  35. 35.
    Teasdale, E., Patterson, J., McLellan, D., Macpherson, P., Subselective preoperative embolization for meningiomas. J. Neurosurg.60 (1984), 506–511.PubMedGoogle Scholar
  36. 36.
    Tilzer, L. L., Plapp, F. V., Evans, J. P., Stone, D., Alward, K., Steroid receptor proteins in human meningiomas. Cancer49 (1982), 633–636.PubMedGoogle Scholar
  37. 37.
    Thomas, H. G., Dolman, C. L., Berry, K., Malignant meningiomas: clinical and pathological features. J. Neurosurg.55 (1981), 929–934.PubMedGoogle Scholar
  38. 38.
    Vaquero, J., Marcos, M. L., Martinez, R., Bravo, G., Estrogen- and progesterone-receptor proteins in intracranial tumors. Surg. Neurol.19 (1983), 11–13.PubMedGoogle Scholar
  39. 39.
    Vihko, R., Jänne, O., Kontula, K., Syrjälä, P., Female sex steroid receptor status in primary and metastatic breast carcinoma and its relationship to serum steroid and peptide hormone levels. Int. J. Cancer26 (1980), 13–21.PubMedGoogle Scholar
  40. 40.
    Yamashita, J., Handa, H., Iwaki, K., Mitsuyaki, A., Recurrence of intracranial meningiomas, with special reference to radiotherapy. Surg. Neurol.14 (1980), 33–40.PubMedGoogle Scholar
  41. 41.
    Yamashita, Y., Kuwabara, T., Estimation of rate of growth of malignant brain tumors by computed tomography scanning. Surg. Neurol.20 (1983), 464–470.PubMedGoogle Scholar
  42. 42.
    Yu, Z.-Y., Wrange, Ö., Haglund, B., Granholm, L., Gustafsson, J.-Å., Estrogen and progestin receptors in intracranial meningiomas. J. Steroid Biochem.16 (1982), 451–456.PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • J. Jääskeläinen
    • 1
  • E. Laasonen
    • 2
  • J. Kärkkäinen
    • 3
  • M. Haltia
    • 4
  • H. Troupp
    • 1
  1. 1.Department of NeurosurgeryHelsinki University Central HospitalHelsinkiFinland
  2. 2.Division of RadiologyHelsinki University Central HospitalHelsinkiFinland
  3. 3.Department of Gynaecology and ObstetricsHelsinki University Central HospitalHelsinkiFinland
  4. 4.Department of PathologyUniversity of HelsinkiHelsinkiFinland

Personalised recommendations