MNGO-10IMPACT OF MULTIPLE SCLEROSIS (MS) AND ITS IMMUNOMODULATORY TREATMENT ON MENINGIOMA OUTCOMES

Abstract

BACKGROUND: Meningioma is rarely described in the MS literature and the influence of immunomodulatory treatment is not known. There are only a few case reports on the relationship of MS and meningioma, some of which suggest progression of disease with MS treatment. METHOD: We retrospectively reviewed patients diagnosed with MS by Macdonald criteria and meningioma from January 1992 to December 2014. RESULTS: We identified 7women, median age of 65(range: 46-69), with both MS and meningioma. Six patients were followed for a median of 9 years (range: 1 month-10 years).Two were never treated with any disease modifying therapy (DMT), 3 were treated with interferon-beta 1a (IFNb-1a), 1 with glatiramer acetate then, natalizumab, and 1 with IFNb-1a then, natalizumab. At the time of meningioma diagnosis, 4 had not been treated with any DMT, 2 were on IFNb-1a, and 1 was on glatiramer acetate. In six cases, meningioma was diagnosed after the MS diagnosis (median of 11 years, range of 0- 21 years). Of the 7 patients identified, meningioma progression necessitated tumor treatment in 4 patients; 3 surgical resections, 1 stereotactic radiosurgery. Histology of all resected tumors was WHO grade I. Of these patients, 2 were on IFNb-1a and 2 never received DMT. The one patient who had stereotactic radiosurgery was on treatment with IFNb-1a during meningioma growth period. This patient had multiple complications due to radiation necrosis. The remaining 3 patients treated for MS did not require treatment of their meningioma. CONCLUSION: In this small series of patients with both MS and meningioma, tumor progression necessitating treatment in patients receiving DMT or off DMT. In the one patient who received stereotactic radiosurgery, radiation caused severe complications.