HORMON THERAPY & ORAL

CONTRACEPTIVE ASSOCIATED
WITH INCREASE RISK OF
MENINGIOMA
Rr Suzy Indharty
Department of Neurosurgery
Universitas Sumatera Utara
 Introduction
• Meningioma is a slow growing, extra-axial tumor, arise from
meningothelial cells found within arachnoid granulations.
• Meningioma: one third of all CNS tumors, can be located
intracranial (>98%) and spinal (<2%)
• Although most are benign (70-75% WHO grade I), a few are
classified as atypical (20-24% WHO grade II), or anaplastic (4%
WHO grad III)
• Metastase are uncommon

Wiemels, J., Wrensch, M., Claus, E.B., 2010. Epidemiology and etiology of meningioma. J Neurooncol 99 (3): 307-314
 EPIDEMIOLOGY
• Peaks age: Fourth decade
• Female preponderance (2x)
• Less than 2% occur in childhood & adolescence
• About 20% of cases seen in adolescents are associated
with NF-1
• May be multiple in up to 8% of cases

Wiemels, J., Wrensch, M., Claus, E.B., 2010. Epidemiology and etiology of meningioma. J Neurooncol 99 (3): 307-314
 Location of Meningioma

Wohrer, A., 2013. Epidemiology of Meningioma. Eur Assoc Neurooncol Mag, 3: 1-3
Choy, W., Kim, W., Nagasawa, D., Stramotas, S., Yew, A., Gopen, Q., et al, 2011. The molecular genetics and tumor pathogenesis of meningiomas and the future
directions of meningioma treatments. Neurosurg Focus, 30 (5): E6
Choy, W., Kim, W., Nagasawa, D., Stramotas, S., Yew, A., Gopen, Q., et al, 2011. The molecular genetics and tumor pathogenesis of meningiomas and the future directions of
meningioma treatments. Neurosurg Focus, 30 (5): E6
EVIDENCE BASED MEDICINE
PRO
EVIDENCE BASED MEDICINE
KONTRA
 Suggestion
• Avoiding HRT in patient with meningioma and family history with
meningioma
• Routine brain MRI without contrast for patient with risk factor
that need HRT and patient that given high dose HRT for long
periods of time.
• There is no solid data about the best screening schedule, based
on expert consensus: Patients with meningioma that need HRT
should have MRI brain with contrast after 6 months then
annually unless symptoms appear.
Care algorithm with intracranial meningiomas

Apra, C., Peyre, M., & Kalamarides, M.

(2018). Current treatment options for meningioma.
Expert Review of Neurotherapeutics, 18(3), 241–
249.doi:10.1080/14737175.2018.1429920
TERIMA KASIH