Hortobágyi Tibor, Bencze János, Murnyák Balázs, Kouhsari Mahan C, Bognár László, Marko-Varga György
Division of Neuropathology, Institute of Pathology, University of Debrecen, Debrecen, Nagyerdei krt. 98., H-4032, Hungary.
Division of Neuropathology, Institute of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Open Med (Wars). 2017 Jul 13;12:195-200. doi: 10.1515/med-2017-0029. eCollection 2017.
Meningioma is among the most frequent brain tumours predominantly affecting elderly women. Epidemiological studies have shown that at the age of fertility the incidence is relatively low. The biological behaviour of meningioma in pregnancy is different from other meningiomas. The possible explanation is rooted in the complex physiological changes and hormonal differences during pregnancy. The increased meningioma growth observed in pregnancy is presumably the result of endocrine mechanisms. These include increase in progesterone, human placental lactogen (hPL) and prolactin (PRL) serum levels. In contrast, levels of pituitary hormones such as follicle stimulating hormone (FSH), luteinizing hormone (LH) and human chorionic gonadotropin (hCG) produced by the placenta are decreasing in the mother prior to childbirth. Besides, vascular factors also play a crucial role. Peritumoral brain edema (PTBE), with well-known causative association with vascular endothelial growth factor (VEGF), can often be seen both with imaging and in the surgical specimens. Our aim is to assess published research on this topic including diagnostic and therapeutic guidelines, and to provide a clinically useful overview on the pathophysiology and biological behaviour of this rare complication of pregnancy.
脑膜瘤是最常见的脑肿瘤之一，主要影响老年女性。流行病学研究表明，在生育年龄时发病率相对较低。妊娠期间脑膜瘤的生物学行为与其他脑膜瘤不同。可能的解释源于妊娠期间复杂的生理变化和激素差异。妊娠期间观察到的脑膜瘤生长增加可能是内分泌机制的结果。这些机制包括孕酮、人胎盘催乳素（hPL）和催乳素（PRL）血清水平的升高。相比之下，胎盘产生的垂体激素如促卵泡激素（FSH）、黄体生成素（LH）和人绒毛膜促性腺激素（hCG）在母亲分娩前水平正在下降。此外，血管因素也起着关键作用。瘤周脑水肿（PTBE）与血管内皮生长因子（VEGF）有众所周知的因果关系，在影像学检查和手术标本中都经常可以看到。我们的目的是评估关于这个主题的已发表研究，包括诊断和治疗指南，并提供关于这种罕见妊娠并发症的病理生理学和生物学行为的临床有用概述。
