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Pituitary Gland Disorders and Treatments · Journal article
Brain Tumor Pathology · September 5, 2026
Early or partial results. Treat as a signal, not a conclusion.
Two case reports document rapid meningioma enlargement temporally associated with leuprorelin acetate initiation in men receiving androgen-deprivation therapy for prostate cancer. Ex vivo culture of resected tumor tissue showed dose-dependent increases in cell viability after leuprorelin exposure, suggesting a possible biologic mechanism in LHRH receptor-positive meningiomas. This constitutes preliminary evidence raising a hypothesis about a potential adverse effect, but does not establish causation or quantify clinical risk.
Case reports with ex vivo mechanistic study. Case 1: 67-year-old man with left cerebellopontine angle meningioma. Case 2: 72-year-old man with atypical meningioma previously treated with subtotal resection and radiotherapy.. Intervention: Leuprorelin acetate (LHRH agonist) initiated for androgen-deprivation therapy; ex vivo exposure of tumor tissue to leuprorelin acetate over 7 days.. Compared with: Ex vivo: control or untreated tissue culture conditions not explicitly described; clinical: baseline tumor imaging before leuprorelin initiation served as implicit control..
Case 1: 67-year-old with left cerebellopontine angle meningioma showing gradual enlargement over 26 months; exhibited accelerated growth after leuprorelin acetate initiation, requiring surgical resection. Case 2: 72-year-old with atypical meningioma stable for 6 years after subtotal resection and radiotherapy; tumor rapidly regrew after leuprorelin acetate initiation and required re-resection. Both cases: resected tumors were LHRH- and LHRH receptor-positive on pathology.
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This case report should alert clinicians to consider baseline imaging and close surveillance for meningioma in patients with known intracranial masses before initiating LHRH agonist therapy. However, the two cases do not establish incidence or define which patients are at risk, and causation cannot be inferred without prospective data.
Two case reports with supporting ex vivo evidence raise a mechanistic hypothesis about LHRH agonists and meningioma growth, but lack controlled comparison, prospective data, or clinical outcome quantification to establish causation or clinical risk.
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This case report should alert clinicians to consider baseline imaging and close surveillance for meningioma in patients with known intracranial masses before initiating LHRH agonist therapy. However, the two cases do not establish incidence or define which patients are at risk, and causation cannot be inferred without prospective data.
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Abstract Luteinizing hormone-releasing hormone (LHRH) agonists are widely used for androgen-deprivation therapy in prostate cancer. Recent reports have raised concern that LHRH may influence the biological behavior of LHRH receptor-expressing intracranial tumors, including meningiomas; however, clinical evidence remains limited. We describe two cases of rapidly progressive meningioma temporally associated with the initiation of leuprorelin acetate. Case 1 was a 67-year-old man with a left cerebellopontine angle meningioma that had demonstrated gradual enlargement over 26 months. Following the initiation of leuprorelin acetate, the tumor exhibited accelerated growth, necessitating surgical resection. Pathology confirmed a fibrous meningioma with LHRH and its receptor positive. Case 2 was a 72-year-old man previously treated with subtotal resection and radiotherapy for an atypical meningioma. After 6 years of radiographic stability, the tumor rapidly regrew soon after leuprorelin acetate initiation and required re-resection. Both the primary and recurrent tumors were LHRH- and LHRH receptor-positive. Freshly resected tumor tissue cultured ex vivo demonstrated a dose-dependent increase in cell viability following 7-day exposure to leuprorelin acetate. These findings suggest that LHRH agonists may be associated with increased cell viability in a subset of receptor-positive meningiomas. Caution is warranted when initiating LHRH agonist therapy in patients with known or suspected meningiomas.
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