Recommendations on the management of meningioma and sex hormone therapy: The results of a collaborative effort between neurosurgical, endocrine and gynecological societies.

IF 1.9 Q3 CLINICAL NEUROLOGY

Brain & spine Pub Date : 2024-12-09 eCollection Date: 2025-01-01 DOI:10.1016/j.bas.2024.104154

Gilles Reuter, Iulia Potorac, Carlien de Herdt, Linda Ameryckx, Géraldine Brichant, Sébastien Froelich, Bertrand Baussart, Steven De Vleeschouwer, Tomas Menovsky, Tony Van Havenberghe, Patrice Finet, Michael Bruneau, Axelle Pintiaux

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Abstract

Introduction: Exogenous and endogenous sex hormones, especially Progesterone agonists, may be causally linked to meningioma progression. Cessation of treatment leads to stabilization or regression of Progestin-induced meningioma. In many cases, avoiding sex hormone therapy may be possible in the context of meningioma treatment. However, hormonal treatment is not always easily replaceable and concise real-world recommendations regarding sex hormones and meningioma are lacking.

Material and methods: A combined effort was initiated between Neurosurgical, Gynaecological and Endocrinological societies of Belgium to gather relevant information regarding sex hormone therapies and meningioma. After complete literature review, consensual recommendations were established.

Results: Collegial recommendations regarding sex hormones therapies and meningioma in the context of oral contraceptives, menopause hormonal treatment, fertility treatment, pregnancy and gender-affirming therapies are emitted and nuanced.

Discussion and conclusion: Withdrawal and monitoring of sex hormone therapies are discussed in detail.A decision tree regarding Meningioma and Combined contraception, Progestin Contraception, Menopause Hormonal treatment, Progestin and Gender-affirming therapy is suggested.

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关于脑膜瘤管理和性激素治疗的建议：神经外科、内分泌和妇科协会合作的成果。

外源性和内源性性激素，尤其是孕激素激动剂，可能与脑膜瘤的进展有因果关系。停止治疗导致孕激素诱导的脑膜瘤稳定或消退。在许多情况下，在脑膜瘤治疗的背景下，避免性激素治疗是可能的。然而，激素治疗并不总是容易替代，并且缺乏关于性激素和脑膜瘤的简明现实建议。材料和方法：比利时神经外科、妇科和内分泌学会共同努力，收集性激素治疗和脑膜瘤的相关信息。在完整的文献回顾后，建立了共识建议。结果：在口服避孕药、更年期激素治疗、生育治疗、怀孕和性别肯定治疗的背景下，关于性激素治疗和脑膜瘤的合议建议被发出和细致入微。讨论与结论：详细讨论了性激素治疗的停药和监测。提出了脑膜瘤与联合避孕、黄体酮避孕、绝经期激素治疗、黄体酮与性别肯定治疗的决策树。

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