Spontaneous Regression Of A Large Skull Base Meningioma: Case Report
Kumaria, A., Ingale, H. A., & Macarthur, D. C. (2020). Spontaneous regression of a large skull base meningioma: case report. British journal of neurosurgery, 34(2), 205–206. https://doi.org/10.1080/02688697.2018.1426728
View Original Source →Abstract
We present the case of a 58 year old lady with a large middle cranial fossa meningioma (5 cm × 4 cm in maximal dimensions) which has considerably regressed without any treatment during seven years of follow up. While the tumour had remained radiologically static for the first three years, scans from year five post-diagnosis onwards have shown shrinkage of the meningioma from a calculated volume of 36 cm<sup>3</sup> to 11.2 cm<sup>3</sup>. There has been no intratumoral haemorrhage or infarction and no medication or exogenous hormonal effect that could account for this effect. We reviewed the literature and report that this is only the second ever case of spontaneous regression of meningioma.
Case Details
Disease Location
Brain
Personal Characteristics
51 year old lady. History of learning disability, anxiety, and type 2 diabetes mellitus.
Clinical Characteristics
Two year history of buzzing tinnitus in her left ear and mild left ear and jaw pain. MRI brain with contrast revealed a large meningioma (4 x 5 x3.6 cm)of the middle cranial fossa extending to the sphenoid wing, petrous ridge, infratemporal fossa, and cavernous sinus encasing the left optic nerve and a segment of the internal carotid artery. Her ear and jaw pain, thought to be related to trigeminal compression, resolved with carbamazepine.
Remission Characteristics
An MRI performed at seven years post-diagnosis showed shrinkage of the meningioma.
Treatment & Mechanisms
Proposed Remission Mechanisms
Physiological sex hormones had been trophic and their withdrawal at menopause has resulted in tumour shrinkage vs microangiopathic changes on a histological level may have contributed to tumour shrinkage
Clinical Treatment
Carvamazepine