Bei
Medline gibt es unter den beiden Suchstichworten >meningioma pregnancy< (ohne die >Anführungszeichen<) aktuell, also heute, 167 Literaturzitate. Drei wichtige führe ich nachfolgend auf. Ich selbst habe mich bisher nur mit dem Thema
Meningeom und Hormonersatztherapie beschäftigt.
Ob dieses winzige Meningeom (das ganz sicher per Zufall gefunden wurde) in der Schwangerschaft wachsen wird? Ich weiß es nicht. Man könnte sich vorstellen, daß es derzeit allein in Deutschland mehrere Hundert schwangere Frauen gibt mit so einem winzigen Meningeom im Kopf, sie wissen bloß nichts davon, weil es kein allgemeines MRT-Screening gibt...
Hier also drei Literaturstellen, herausgesucht aus 167 angebotenen.
1
Management Strategy for Meningioma in Pregnancy: A Clinical Studyhttp://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=15912178Man kann - das ist ungewöhnlich - den ganzen Artikel online lesen.
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Can J Neurol Sci. 2005 Feb;32(1):122-7
2
Sex steroid and growth factor profile of a meningioma associated with pregnancy.Smith JS, Quinones-Hinojosa A, Harmon-Smith M, Bollen AW, McDermott MW.
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California 94143-0112, USA.
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.
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J Neurosurg. 2003 Nov;99(5):848-53.
3
Sex steroid hormone exposures and risk for meningioma.Jhawar BS, Fuchs CS, Colditz GA, Stampfer MJ.
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. bjhawar@post.harvard.edu
OBJECT: The goal of this study was to investigate the risk of meningioma in relation to exogenous and endogenous sex hormones.
METHODS: The study participants were female registered nurses from 11 US states who were between 30 and 55 years of age when they enrolled in the Nurses' Health Study cohort. These women completed biennial questionnaires between 1976 and 1996. All participants were free from cancer and other major medical illness at the onset of the study. The primary endpoint was meningioma as self-reported in biennial and supplemental questionnaires. During 1,213,522 person-years of follow-up review, 125 cases of meningioma were confirmed. After adjusting for age and body mass index (BMI), compared with postmenopausal women who had never used postmenopausal hormones, the relative risk (RR) for premenopausal women was 2.48 (95% confidence interval [CI] 1.29-4.77; p = 0.01) and the RR for postmenopausal women who received hormone therapy was 1.86 (95% CI 1.07-3.24; p = 0.03). The authors found no excess risk associated with past hormone use. In models that additionally controlled for hormone use and menopausal status, the authors found that, compared with women whose menarche occurred before they were 12 years of age, the RR for women whose menarche occurred at ages 12 through 14 years was 1.29 (95% CI 0.86-1.92; p = 0.21) and the RR for women whose menarche occurred after age 14 years was 1.97 (95% CI 1.06-3.66; p = 0.03). The authors also observed a tendency, albeit nonsignificant, for increased risk of meningioma in parous as opposed to nulliparous women (multivariate RR = 2.39, 95% CI 0.76-7.53; p = 0.14). A trend toward an increasing risk of meningioma with increasing BMI was also noted (p for trend = 0.06). No association was found for past or current use of oral contraceptives.
CONCLUSIONS: The risk for meningiomas was increased among women exposed to either endogenous or exogenous sex hormones. An unexpected relationship with increasing age at menarche was also noted; this remains unexplained.
