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Vol. 32. Issue 4.
Pages 188-193 (July - August 2021)
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Vol. 32. Issue 4.
Pages 188-193 (July - August 2021)
Caso clínico
Involución espontánea de meningioma. Caso clínico y revisión de la literatura
Spontaneus involution of meningioma. Case report and literature review
Marta Ortega Martínez
Corresponding author
marta.ort@hotmail.com

Autor para correspondencia.
, Ignacio Gilete Tejero, David Miranda Zambrano, Iria Gestoso Ríos, María Rico Cotelo, Manuel Royano Sánchez
Servicio de Neurocirugía, Complejo Hospitalario Universitario de Cáceres, Cáceres, España
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Tabla 1. Relación de meningiomas involucionados sin relación con tratamiento hormonal
Resumen

Los meningiomas son tumores de las meninges cerebrales, de crecimiento lento y generalmente benignos, cuyo tratamiento es esencialmente quirúrgico. Presentan receptores de progesterona, y en menor medida de estrógeno, lo que les hace a veces tener crecimiento o disminución ligada a tratamiento hormonal. Es extremadamente raro que presenten involución espontánea. Presentamos el caso de un varón con un meningioma del planum esfenoidal. Como antecedentes tenía diabetes mellitus, miastenia gravis y un cáncer de próstata. Como tratamiento médico recibía, entre otros, análogos de la gonadotropina (leuprorelina), antiandrogénico (bicalutamida), agonistas β3 y bloqueantes α1. A los 15 meses del bloqueo hormonal se objetivó una reducción del tumor del 90% de su volumen. Los casos publicados previamente muestran que el tratamiento con análogos de la GnRH produce un crecimiento en algunos meningiomas. Existen otros casos publicados sobre reducción en pacientes diabéticos y en tratamiento con bloqueantes α1. Se revisa la literatura sobre meningiomas con involución espontánea.

Palabras clave:
Involución tumoral
Meningioma
Diabetes mellitus
Alfa bloqueantes
Análogos gonadotropina
Abstract

Meningiomas are tumors of the cerebral meninges, with slow growth and usually benign, whose treatment is essentially surgery. They have progesterone receptors, and to a lesser extent estrogen, which sometimes causes them to have growth or involution linked to hormonal treatment. Its spontaneous involution is extremely rare. We present the case of a male with a meningioma of the sphenoid planum. He had a history of diabetes mellitus, myasthenia gravis and prostate cancer. He was in treatment with analogs of GnRH (leuprorelin), antiandrogen (bicalutamide), β3 agonists and α1 blockers. 15 months after the hormonal blockade, a reduction of the tumor of approximately 90% of its volume was detected. Previous reports show that treatment with gonadotropin analogues produces growth in some meningiomas. Other reports of spontaneous involution affect diabetic patients and patients in treatment with α1 blockers. Literature focus on meningiomas with spontaneous involution is reviewed.

Keywords:
Tumor involution
Meningioma
Diabetes mellitus
Alfa blockers
Gonadotropin analogues

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