Sex steroid and epidermal growth factor profile of giant meningiomas associated with pregnancy

Surg Neurol. 2008 Apr;69(4):356-62; discussion 362-3. doi: 10.1016/j.surneu.2007.03.013. Epub 2007 Aug 17.


Background: An association between meningioma, breast cancer, and increased growth of meningiomas during pregnancy, and the luteal phase of the menstrual cycle have been shown in previous reports, but the mechanisms still remain unclear. These data suggest that sex steroids and growth factors may have a role in the growth of meningiomas. This is an important factor to consider during the development of more effective nonsurgical treatment options.

Methods: We described 3 patients with meningioma who presented during the early postpartum period. The lesions were completely resected, and immunohistochemical evaluation of PR, ER, EGF receptor, and Ki67 antigen was performed.

Results: Pathologic studies of tumor specimens revealed atypical meningioma (grade 2), syncytial meningioma (grade 1), and transitional-psammomatous meningioma (grade 1), for cases 1, 2, and 3, respectively. Immunohistochemical studies demonstrated positive PR staining in all of the cases, and there was no immunostaining for ER in any of the cases. Immunohistochemistry for EGF receptor showed membranous staining in less than 10% of the tumor cells, membranous staining in more than 50% of the tumor cells, and no staining in cases 1, 2, and 3, respectively. Immunohistochemistry for Ki67 resulted in positive staining in 20% of the tumor cells for case 1, 10% for case 2, and less than 5% for case 3.

Conclusions: Although many reports indicating an association between meningioma and pregnancy have been published, the number of immunohistochemical studies is limited. This study suggested the importance of targeting the PR, Ki67 antigen, and EGF receptor in the development of nonsurgical therapeutic regimens.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • ErbB Receptors / metabolism*
  • Female
  • Humans
  • Ki-67 Antigen / metabolism*
  • Meningeal Neoplasms / metabolism*
  • Meningeal Neoplasms / pathology
  • Meningioma / metabolism*
  • Meningioma / pathology
  • Puerperal Disorders / metabolism*
  • Puerperal Disorders / pathology
  • Receptors, Steroid / metabolism*


  • Ki-67 Antigen
  • Receptors, Steroid
  • ErbB Receptors