Variation of meningioma in response to cyproterone acetate in a trans woman

Background: Meningiomas express estrogen and progesterone receptors, suggestive of hormonal responsiveness. So far, eight cases of trans women with a meningioma have been reported in the literature. Methods: Detailed report of the symptoms, treatment, and follow-up of an individual transgender patient with a meningioma. Results: A trans woman treated long-term with gender affirming hormone therapy, including cyproterone acetate, a synthetic progestin and anti-androgen, was diagnosed with a meningioma, significantly expanding in volume over 10 years. After stopping cyproterone acetate a substantial volume decrease of the meningioma was noticed within 3 months. Conclusion: This addition to the literature demonstrates that a conservative approach with interruption of cyproterone acetate may be a sufficient intervention, obviating the need for additional neurosurgical treatment