title: Unresectable Recurrent Multiple Meningioma: A Case Report with Radiological Response to Somatostatin Analogues.
abstract: Medical treatment of meningiomas is reserved for cases in which surgery and radiotherapy have failed. Given that a high percentage of meningiomas express somatostatin receptors, treatment with somatostatin analogues has been proposed. In addition, these medications have been shown to have an antiproliferative and antiangiogenic effect in vitro. To date, very few cases with clinical response and none with radiological response have been described. The case described here is the first to report a radiological response. A 76-year-old Caucasian male was first diagnosed with unresectable meningioma at age 47. The patient experienced multiple recurrences and underwent three surgeries and radiotherapy over the years from the initial diagnosis. Despite treatment, the disease continued its progression. Based on an Octreoscan positive for tumour uptake, therapy with extended-release somatostatin analogues was started. Although no clinical neurological improvement was observed, magnetic resonance imaging scans revealed a discreet but continuous radiological response over time. After >2 years of continuous administration of lanreotide, the patient remains progression free. In highly selected cases, somatostatin analogue treatment for meningioma may be beneficial. Based on our findings, treatment with somatostatin analogues should be maintained longer than previously described before evaluating treatment response.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Ortolá Buigues
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Crespo Hernández
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Jorquera Moya
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Jose Ángel
authors.initials: JÁ
authors.lastname: Díaz Pérez
keywords: Meningeal neoplasms; Meningioma; Octreotide; Somatostatin; Somatostatin receptors