Endocrine Abstracts

A 40-year-old transfemale, regularly treated with oral estradiol (2 mg per day) and CPA (100 mg per day) for the last 15 years, presented with two asymptomatic intracranial lesions on compatible with meningiomas. Gender dysphoria since the age of 14, begins treatment in 2006. Paranoid schizophrenia at age 17. She referred to occasional headaches, without neurological defect. In the year 2013, a magnetic resonance imaging (MRI) scan revealed an expansive lesion over the sphenoidal planum. Prior MRI in 2007 was normal. Complete endoscopic resection was performed via intranasal of the meningioma of the sphenoidal planun. The immunohistochemical and morphological tests revealed a WHO grade I meningioma. Annual follow-up using contrast-enhanced MRI scan was performed after that. In 2018, the MRI scan showed the presence of one menigioma of 1.1 cm in the right frontal area and another of less than 1 cm at the level of the anterior clinoid processes. CPA was discontinued and was substituted with triptorelin acetate Our patient was treated for more than 10 years with cyproterone acetate with the appearance of a new menigioma again. The patient maintained high doses of CPA due to lack of alternative and severe hirsutism. It showed a recurrence of multiple of meningiomas during the follow-up. Our case confirms the clinical association between the administration of CPA and the presence of menigioma. These menigiomas appear after 5 years of treatment with high dose CPA. Proper treatment of the initial tumor does not exclude withdrawal of the CPA because of recurrence and multiple meningiomas in other brain locations. The occurrence of meningiomas in transfemale is uncommon and asymptomatic multiple tumors should be considered with the use of CPA. CPA should be removed. A literature review were done