title: Symptomatic meningioma induced by cross-sex hormone treatment in a male-to-female transsexual.
abstract: Transsexualism is defined as a strong conviction of belonging to the opposite sex in individuals without any physical intersex condition. Cross-sex hormone therapy is an important component of medical treatment of transexuals but it is not exempt from adverse effects. We report a case of a meningioma in a male-to-female transsexual patient treated with estrogens and cyproterone acetate for the past 4 years. He claimed recently severe headache and visual impairment. Blood tests showed normal results. A contrast-enhanced magnetic resonance imaging (MRI) scan revealed a mass in the tuberculum sellae consistent with a meningioma. Treatment was discontinued and tumor resection was performed. Histologic diagnosis confirmed strongly progesterone receptor-positive and estrogen negative meningioma. After surgery, the patient rejected the possibility of continuing with the treatment of estrogens and cyproterone, and so triptorelin (GnRH agonist) was initiated. At 1-year follow-up the patient's symptoms had ameliorated and a MRI scan revealed no recurrence of the tumor. This is the third case reported in the literature of a meningioma after treatment with estrogens and cyproterone acetate. We consider extremely important a long-term follow-up observation of male-to-female transsexual undergoing cross-sex hormone therapy in order to detect as soon as possible the adverse effects that can be derived from this therapy.
authors.affiliation: Department of Endocrinology, Doctor Peset University Hospital, Valencia, Spain. drabergoglio@gmail.com
authors.forename: Marina T
authors.initials: MT
authors.lastname: Bergoglio
authors.forename: Marcelino
authors.initials: M
authors.lastname: Gómez-Balaguer
authors.forename: Elena
authors.initials: E
authors.lastname: Almonacid Folch
authors.forename: Felipe
authors.initials: F
authors.lastname: Hurtado Murillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández-Mijares
mesh_terms: D000328:Adult; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000009:adverse effects*; D006801:Humans; D008577:Meningeal Neoplasms / Q000139:chemically induced*; D008579:Meningioma / Q000139:chemically induced* / Q000175:diagnosis; D014189:Transsexualism / Q000188:drug therapy*
chemical_list: D004967:Estrogens; D012739:Gonadal Steroid Hormones