Petroclival meningioma regression after combined oestrogen and nomegestrol acetate interruption

BMJ Case Rep. 2025 Jan 19;18(1):e263529. doi: 10.1136/bcr-2024-263529.

Abstract

Meningioma regression after progestin treatment interruption is already established. Zoely is a combined oral contraceptive including oestradiol and progestin (nomegestrol acetate). The effect of combined oestrogen with nomegestrol acetate on meningioma is currently unknown. We report the case of a woman in her early 50s under Zoely for 5 years who was diagnosed with a large petroclival meningioma. After cessation of Zoely, the patient showed clinical improvement and shrinkage of the tumour volume from 27.22 cm3 to 20.54 cm3 in 6 months. This is probably the first report of spontaneous meningioma regression after Zoely interruption.

Keywords: Contraception; Drug therapy related to surgery; Neurooncology.

Publication types

  • Case Reports

MeSH terms

  • Estrogens / administration & dosage
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Megestrol* / administration & dosage
  • Megestrol* / therapeutic use
  • Meningeal Neoplasms* / drug therapy
  • Meningioma* / diagnostic imaging
  • Meningioma* / drug therapy
  • Middle Aged
  • Neoplasm Regression, Spontaneous
  • Norpregnadienes* / administration & dosage
  • Norpregnadienes* / therapeutic use
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / drug therapy

Substances

  • Norpregnadienes
  • Megestrol
  • nomegestrol acetate
  • Estrogens