Do hormonal contraceptives stimulate growth of neurofibromas? A survey on 59 NF1 patients.
BACKGROUND
Neurofibromas are benign tumors of the peripheral nerves and hallmark of neurofibromatosis type 1 (NF1), a tumor suppressor gene syndrome. Neurofibromas mostly start developing at puberty and can increase in size and number during pregnancy. Expression of progesterone receptors has been found in 75% of the tumors. Many female NF1 patients are thus concerned about the possibility that hormonal contraceptives may stimulate the growth of their neurofibromas.


METHODS
A survey was carried out on 59 female NF1 patients who are practicing or have practiced hormonal contraception to examine the effect of the various contraceptives on the growth of neurofibromas.


RESULTS
Majority (53 out of 58) of patients who received oral estrogen-progestogen or pure progestogen preparations reported no associated tumor growth. In contrast, significant tumor growth was reported by two patients who received depot contraceptive containing high dose of synthetic progesterone.


CONCLUSIONS
Oral contraceptives do not seem to stimulate the growth of neurofibromas in NF1 patients. High doses of progesterone might stimulate the growth of neurofibromas and deserve more caution.
Lammert
Marge
M
Department of Maxillofacial Surgery, University Hospital Eppendorf, Hamburg, Germany. kluwe@uke.uni-hamburg.de
Mautner
Victor-Felix
VF
Kluwe
Lan
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009456:Neurofibromatosis 1 / Q000139:chemically induced* / Q000473:pathology; D011374:Progesterone / Q000009:adverse effects
D003277:Contraceptives, Oral, Combined; D011374:Progesterone; D017258:Medroxyprogesterone Acetate