J Neurol Surg Rep 2016; 77(01): e62-e65
DOI: 10.1055/s-0035-1571204
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Regression of Intracranial Meningioma during Treatment with α1-Adrenoceptor Blocker

Einar August Hoegestoel
1   Department of Neurosurgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
,
Jon Berg-Johnsen
1   Department of Neurosurgery, Oslo University Hospital Rikshospitalet, Oslo, Norway
2   Faculty of Medicine, University of Oslo, Oslo, Norway
› Author Affiliations
Further Information

Publication History

31 August 2015

03 December 2015

Publication Date:
11 May 2016 (online)

Abstract

Background Regression of meningioma has been reported after hemorrhage or hormonal withdrawal. Here, we report a case of an incidentally diagnosed meningioma that regressed in association with α1-adrenoceptor antagonist.

Case report A 59-year old male patient with an incidentally diagnosed lateral sphenoid wing meningioma was followed with serial magnetic resonance imaging. The tumor with a maximum diameter of 43 mm showed progressive regression, and after 3 years the size was reduced to 22% of the initial volume. During follow-up the patient was treated with an α1-adrenoceptor antagonist (tamsulosin) for benign prostatic hyperplasia. Possible mechanisms are discussed, including our main hypothesis of reduced mitogenic effects through phospholipase C-signal transduction.

Conclusion This is the first report of regression of an incidentally diagnosed meningioma associated with α1-adrenoceptor antagonist treatment.

Note

An abstract of this case history was presented at the Annual Meeting of the Norwegian Neurosurgical Society; October 26, 2014; Norway.


 
  • References

  • 1 Yoneoka Y, Fujii Y, Tanaka R. Growth of incidental meningiomas. Acta Neurochir (Wien) 2000; 142 (5) 507-511
  • 2 Shimizu J, Matsumoto M, Yamazaki E, Yasue M. Spontaneous regression of an asymptomatic meningioma associated with discontinuation of progesterone agonist administration. Neurol Med Chir (Tokyo) 2008; 48 (5) 227-230
  • 3 Gonçalves AMG, Page P, Domigo V, Méder J-F, Oppenheim C. Abrupt regression of a meningioma after discontinuation of cyproterone treatment. AJNR Am J Neuroradiol 2010; 31 (8) 1504-1505
  • 4 Vadivelu S, Sharer L, Schulder M. Regression of multiple intracranial meningiomas after cessation of long-term progesterone agonist therapy. J Neurosurg 2010; 112 (5) 920-924
  • 5 de Almeida JPC, Petteys RJ, Sciubba DM, Gallia GL, Brem H. Regression of intracranial meningioma following intratumoral hemorrhage. J Clin Neurosci 2009; 16 (9) 1246-1249
  • 6 Hirota K, Fujita T, Akagawa H, Onda H, Kasuya H. Spontaneous regression together with increased calcification of incidental meningioma. Surg Neurol Int 2014; 5: 73
  • 7 Sughrue ME, Rutkowski MJ, Aranda D, Barani IJ, McDermott MW, Parsa AT. Treatment decision making based on the published natural history and growth rate of small meningiomas. J Neurosurg 2010; 113 (5) 1036-1042
  • 8 Wen PY, Quant E, Drappatz J, Beroukhim R, Norden AD. Medical therapies for meningiomas. J Neurooncol 2010; 99 (3) 365-378
  • 9 Wolfsberger S, Doostkam S, Boecher-Schwarz HG , et al. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004; 27 (4) 238-245
  • 10 Bergoglio MT, Gómez-Balaguer M, Almonacid Folch E, Hurtado Murillo F, Hernández-Mijares A. Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexual. Endocrinol Nutr 2013; 60 (5) 264-267
  • 11 Gruber TJ, Fabiano AJ, Deeb G, Lele SB, Fenstermaker RA. Intracranial meningiomas in patients with uterine sarcoma treated with long-term megestrol acetate therapy. World Neurosurg 2011; 76 (5) 477.e16-477.e20
  • 12 Grunberg SM, Weiss MH, Spitz IM , et al. Treatment of unresectable meningiomas with the antiprogesterone agent mifepristone. J Neurosurg 1991; 74 (6) 861-866
  • 13 Koide SS. Mifepristone. Auxiliary therapeutic use in cancer and related disorders. J Reprod Med 1998; 43 (7) 551-560
  • 14 Touat M, Lombardi G, Farina P, Kalamarides M, Sanson M. Successful treatment of multiple intracranial meningiomas with the antiprogesterone receptor agent mifepristone (RU486). Acta Neurochir (Wien) 2014; 156 (10) 1831-1835
  • 15 Kyprianou N, Vaughan TB, Michel MC. Apoptosis induction by doxazosin and other quinazoline α1-adrenoceptor antagonists: a new mechanism for cancer treatment?. Naunyn Schmiedebergs Arch Pharmacol 2009; 380 (6) 473-477
  • 16 Gotoh A, Nagaya H, Kanno T, Nishizaki T. Antitumor action of α(1)-adrenoceptor blockers on human bladder, prostate and renal cancer cells. Pharmacology 2012; 90 (5–6) 242-246
  • 17 Masachika E, Kanno T, Nakano T, Gotoh A, Nishizaki T. Naftopidil induces apoptosis in malignant mesothelioma cell lines independently of α1-adrenoceptor blocking. Anticancer Res 2013; 33 (3) 887-894
  • 18 Mikami K, Nagaya H, Gotoh A , et al. Naftopidil is useful for the treatment of malignant pleural mesothelioma. Pharmacology 2014; 94 (3–4) 163-169
  • 19 Harris AM, Warner BW, Wilson JM , et al. Effect of α1-adrenoceptor antagonist exposure on prostate cancer incidence: an observational cohort study. J Urol 2007; 178 (5) 2176-2180