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Meningioma growth and interferon beta-1b treated multiple sclerosis: coincidence or relationship?
A Drevelegas1, E Xinou, D Karacostas
1Department of Radiology, AHEPA University Hospital, Aristotele University School of Medicine, Thessaloniki, Greece. adrev@med.auth.gr
Abstract:
Although the coincidence of multiple sclerosis (MS) and central nervous system (CNS) tumors has been reported in over 30 cases in English literature, meningioma growth was associated with interferon-beta (INF-b) treated MS only in two of them. We report the case of a 19-year-old woman with clinically possible, laboratory supported MS, and a concomitant right intraventricular tumor with magnetic resonance imaging (MRI) characteristics consistent with meningioma (similar signal with grey matter on T1 and T2-weighted images and homogenous, intense enhancement). Two years after initiation of INF-b treatment, follow-up brain MRI revealed enlargement of the intraventricular mass and relative increase in the number of white matter lesions without significant clinical deterioration. She underwent almost total resection of the mass and histology confirmed the diagnosis of papillary meningioma. Based on the immunohistochemistry results, we speculate that INF-b resulted in meningioma growth by enhancing platelet derived growth factor (PDGF) receptors or/and down-regulating transforming growth factor receptors on the tumor itself.
Insights
This case study highlights a rare instance of meningioma growth in a patient with multiple sclerosis (MS) during interferon-beta (INF-b) treatment. The findings suggest INF-b may influence tumor growth through specific growth factor receptor pathways.
Area of Science:
- Neuro-oncology
- Immunology
- Neurology
Background:
- Co-occurrence of multiple sclerosis (MS) and central nervous system (CNS) tumors is rare.
- Meningioma growth linked to interferon-beta (INF-b) treatment in MS patients is exceptionally uncommon, with only two prior reports.
Observation:
- A 19-year-old woman with clinically diagnosed MS presented with an intraventricular tumor.
- Magnetic resonance imaging (MRI) revealed characteristics consistent with meningioma.
- Following two years of INF-b treatment for MS, the meningioma enlarged, alongside an increase in white matter lesions, without significant clinical decline.
Findings:
- Histological analysis confirmed the tumor as a papillary meningioma.
- Immunohistochemistry suggests INF-b may promote meningioma growth by upregulating platelet-derived growth factor (PDGF) receptors and/or downregulating transforming growth factor receptors.
Implications:
- This case raises awareness about potential interactions between MS therapies and CNS tumors.
- Further research is warranted to elucidate the mechanisms by which INF-b might influence meningioma development.
- Understanding these interactions could inform treatment strategies for MS patients with co-existing tumors.
