Expression of progesterone receptors in meningioma patients: serial case

Meningioma is a tumor that arises from the meningothelial cells of the arachnoid membranes which are attached to the dura mater. Meningioma is one of the most common tumors found in people and occurs more commonly in women due to the link with the progesterone hormones. The risk of developing meningiomas is increased in patients who are exposed to exogenous progesterone such as hormonal contraceptives. This case report must be reported because the hormonal contraceptives are largely used in Indonesia and it is important to report this case. It is reported in three cases of female patients aged 58 years, 46 years, and 38 years with the main complaint of chronic progressive headache and decreased consciousness with left hemiparesis. All patients had a history of using hormonal contraceptives for more than four years. Head CT scans were carried out and obtained the results of extra-axial masses in the supratentorial region of all three patients. Therapeutic management was performed by resection with the result of immunohistochemistry of the three patients showing an expression of progesterone receptor > 90% in the tumor cell nucleus. Progesterone receptors were found in patients with meningioma. The expression of progesterone receptors on tumor cell nuclei is related to prognosis. A positive progesterone receptor will be adopted with a better prognosis. Hormonal therapy such as antiprogesterone can inhibit the genetic mutation of meningioma. Yet, it is not recommended because there is no significant clinical evidence.