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Female gender and exogenous progesterone exposition as risk factors for spheno-orbital meningiomas

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Abstract

Objective

The great heterogeneity of meningiomas is challenging and we need to distinguish relevant subgroups. Spheno-orbital osteomeningiomas (SOOM) constitute a clinically specific entity, with slow-growing benign osteo-meningiomatous tumors, which recur after surgery in one fourth of cases. Neurosurgical daily practice, supported by the literature, shows that the vast majority of patients with SOOM are women, and we explored whether their epidemiological and hormonal profiles suggest a progesterone influence.

Methods

We retrospectively documented all radiologically and histologically confirmed cases of SOOM operated in 2005–2019 in our institution. We completed the clinical and hormone history by systematic telephone interviews.

Results

In the literature, SOOM occur significantly more often in women than other meningiomas (749/847, 86.4% versus 73.8%, p = 0.002). Among 175 cases, we included 124 patients, 93.5% were women, younger than men (51 ± 5 versus 63 ± 8, p = 0.02). Women’ meningiomas showed more progesterone receptors (96.4% versus 50%, p < 0.001). Exogenous hormonal intake, reliable in 82 cases, concerned 83.3% (64/78) of women, with frequent progesterone intake: 13 oestroprogestogenic treatment only, with old-generation progesterone analogs, 41 progesterone analogs (cyproterone acetate, nomegestrol acetate, chlormadinone, promegestone, etonogestrel, levonogestrel), 7 substitutive hormonal therapy for menopause, 3 others. Duration of treatment was 2–40 years, median 10 years.

Conclusions

SOOM develop preferentially in women in their fifties, who often received progesterone analogs, and show progesterone receptors. Progesterone analogs are incriminated in skull base meningiomas, and this is the first report on the prevalence of exogenous hormone therapy specifically in SOOM. Whether SOOM reduce after treatment discontinuation, in particular the osteoma part, needs to be explored. Anti-progesterone treatments may represent an avenue for future research in soom.

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Authors and Affiliations

  1. Neurosurgery Department, Hôpital Pitié Salpêtrière, 43-87 bd de l’Hôpital, 75013, Paris, France

    Caroline Apra

  2. Sorbonne Université, Paris, France

    Caroline Apra

  3. Neurosurgery Department, Centre Hospitalo-Universitaire, Bordeaux, France

    Paul Roblot

  4. Université de Bordeaux, Bordeaux, France

    Paul Roblot

  5. Neurosurgery Department, Hôpital Fondation Adolphe de Rothschild, Paris, France

    Abdu Alkhayri, Caroline Le Guérinel & Dorian Chauvet

  6. Pathology Department, Hôpital Lariboisière, Paris, France

    Marc Polivka

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  1. Caroline Apra
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Apra, C., Roblot, P., Alkhayri, A. et al. Female gender and exogenous progesterone exposition as risk factors for spheno-orbital meningiomas. J Neurooncol 149, 95–101 (2020). https://doi.org/10.1007/s11060-020-03576-8

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