{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:29Z","timestamp":1788308249866,"version":"build-2803163510"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to assess the clinical and radiographic changes in meningioma burden following cessation of depo-medroxyprogesterone acetate (dMPA) in patients with meningioma stabilization or shrinkage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective case series included 3 patients with meningioma who did not undergo resection at the author\u2019s institution but who discontinued dMPA during tumor surveillance (2020\u20132025) and experienced tumor regression. Data collection included meningioma characteristics, previous pathology reports, tumor size across various follow-up time points, and clinical course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The mean cumulative duration of dMPA was 19.7 \u00b1 2.5 years. Tumor regression was identified as early as 14 months after cessation of dMPA and persisted beyond 68 months after cessation. Patient A, with \u2265 20 tumors, demonstrated nearly 39% reduction in overall tumor burden across 45 months. Patient B demonstrated nearly 80% decrease in tumor burden across 68 months. Patient C demonstrated a 6% decrease in tumor burden, with near-complete resolution of 1 anterior skull-base tumor, within 14 months of dMPA cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors present 3 patients with previously diagnosed meningioma who were managed with active surveillance and dMPA cessation. After 12 months of follow-up, all patients demonstrated decreases in overall tumor burden. These results highlight an evolving understanding in the management of patients with possible progestin-associated meningioma in the setting of dMPA exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.6.focus26225","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:57Z","timestamp":1787702457000},"page":"E3","source":"Crossref","is-referenced-by-count":0,"title":["Meningioma regression following discontinuation of depot medroxyprogesterone acetate"],"prefix":"10.3171","volume":"61","author":[{"given":"Alan","family":"Gordillo","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav","family":"Kumar","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Gonugunta","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine, Cleveland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Torres-Trejo","sequence":"additional","affiliation":[{"name":"Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranay","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland;"},{"name":"Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo F.","family":"Recinos","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland;"},{"name":"Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun R.","family":"Kshettry","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland;"},{"name":"Rose Ella Burkhardt Brain Tumor & Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"5","key":"b1","series-title":"Diagn Basel Switz","first-page":"538","article-title":"Malignant meningiomas: from diagnostics to treatment","volume":"15","author":"Rowbottom H","year":"2025","unstructured":"Rowbottom H, \u0160migoc T, Ravnik J. 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Cancers (Basel). 2024;16(19):3362. doi:10.3390\/cancers16193362"},{"issue":"4","key":"b4","series-title":"Clin Neurol Neurosurg","first-page":"261","article-title":"Genetic and molecular alterations in meningiomas","volume":"113","author":"Alexiou GA","year":"2011","unstructured":"Alexiou GA, Markoula S, Gogou P, Kyritsis AP. Genetic and molecular alterations in meningiomas. Clin Neurol Neurosurg. 2011;113(4):261\u2013267. doi:10.1016\/j.clineuro.2010.12.007"},{"issue":"3","key":"b5","series-title":"Cancers (Basel)","first-page":"980","article-title":"Hormone receptor expression in meningiomas: a systematic review","volume":"15","author":"Agopiantz M","year":"2023","unstructured":"Agopiantz M, Carnot M, Denis C, Martin E, Gauchotte G. Hormone receptor expression in meningiomas: a systematic review. Cancers (Basel). 2023;15(3):980. doi:10.3390\/cancers15030980"},{"issue":"4","key":"b6","series-title":"Neurosurg Rev","first-page":"238","article-title":"Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature","volume":"27","author":"Wolfsberger S","year":"2004","unstructured":"Wolfsberger S, Doostkam S, Boecher-Schwarz HG,  Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev. 2004;27(4):238\u2013245. doi:10.1007\/s10143-004-0340-y"},{"key":"b7","series-title":"BMJ","first-page":"e078078","article-title":"Use of progestogens and the risk of intracranial meningioma: national case-control study","volume":"384","author":"Roland N","year":"2024","unstructured":"Roland N, Neumann A, Hoisnard L,  Use of progestogens and the risk of intracranial meningioma: national case-control study. 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