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Sex Steroid and Growth Factor Profile of a Meningioma Associated with Pregnancy

Published online by Cambridge University Press:  02 December 2014

Justin S. Smith ,
Alfredo Quiñones-Hinojosa ,
Miranda Harmon-Smith ,
Andrew W. Bollen  and
Michael W. McDermott
Justin S. Smith
Affiliation:
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California USA
Alfredo Quiñones-Hinojosa
Affiliation:
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California USA
Miranda Harmon-Smith
Affiliation:
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California USA
Andrew W. Bollen
Affiliation:
Department of Pathology, University of California at San Francisco, San Francisco, California USA
Michael W. McDermott
Affiliation:
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California USA
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Abstract

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Background:

Increased growth of meningiomas during pregnancy as well as postpartum clinical regression of symptoms have been reported but remain poorly understood. A better understanding of the factors that contribute to these observations, including potential factors associated with pregnancy, could enable design of more effective adjuvant therapies.

Methods:

We describe the presentation of a meningioma during the immediate postpartum period. Serial imaging demonstrated subsequent rapid decrease in size of the tumour prior to any intervention. The lesion was resected, and the tissue was subjected to immunostaining for gene products associated with pregnancy, including estrogen receptor (ER), progesterone receptor (PR), platelet-derived growth factor receptor B (PDGFRB), fibroblastic growth factor receptor 2 (FGFR-2), epidermal growth factor receptor (EGFR) and human placental lactogen (hPL).

Results:

The lesion proved to be an atypical fibroblastic meningioma grade II (WHO). Immunostaining demonstrated significant staining for PR, PDGFRB, and FGFR-2. No specific staining for ER, EGFR, or hPL was identified.

Conclusion:

Although clinical regression of meningioma following pregnancy is well-recognized, imaging data are much less abundant. This report provides clear clinical and imaging documentation of a meningioma associated with pregnancy. In addition, the growth factor profile of this tumour suggests the importance of PR, PDGFRB, and FGFR-2 as potential therapeutic targets.

Résumé:

RÉSUMÉ:Introduction:

Une augmentation de la croissance de méningiomes pendant la grossesse ainsi Qu’une régression clinique post–partum des symptômes ont déjà été rapportés. Cependant la compréhension de ces phénomènes demeure limitée. Une meilleure compréhension des facteurs qui contribuent à ces observations, particulièrement de facteurs pouvant être associés à la grossesse, pourrait aider au développement de meilleurs traitements adjuvants.

Méthodes:

Nous décrivons l’évolution d’un méningiome pendant la période immédiate du post–partum. L’imagerie en série a montré une diminution rapide de la taille de la tumeur avant toute intervention. La lésion a été enlevée et soumise à un immunomarquage pour des substances associées à la grossesse, dont les récepteurs des oestrogènes (RO), le récepteur de la progestérone (RP), le récepteur B du facteur de croissance dérivé des plaquettes (PDGFRB), le récepteur 2 du facteur de croissance fibroblastique FGFR–2), le récepteur du facteur de croissance épidermique (EGFR) et l’hormone lactogène placentaire humaine (hLP).

Résultats:

La lésion a été classifiée comme un méningiome fibroblastique de grade II (OSM). À l’immunomarquage, on a observé une coloration importante pour le RP, le PDGFRB et le FGFR–2 et aucune coloration pour le RO, l’EGFR ou le hLP.

Conclusion:

Bien que la régression clinique des méningiomes après la grossesse soit bien connue, il y a peu de données sur son imagerie. Cet article présente le tableau clinique et l’imagerie d’un méningiome associé à une grossesse. De plus, le profil des facteurs de croissance de cette tumeur suggère que le RP, le PDGFRB et le FGFR– 2 pourraient être des cibles thérapeutiques importantes.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 1 , February 2005 , pp. 122 - 127
Copyright
Copyright © The Canadian Journal of Neurological 2014

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