Progesterone and Estrogen Receptors in Meningiomas – A Clinicopathological Analysis


  • Aparna Govindan Department of Pathology, Govt. Medical College, Kozhikode, Kerala, India
  • Jacob Paul Alapatt Former Professor and Head, Department of Neurosurgery, Govt. Medical College, Kozhikode, Kerala, India



Meningioma, Immunohistochemistry, Progesterone receptor, estrogen receptor, MIB-1


Background: Meningiomas are common tumors of the Central Nervous System. Recurrence in meningiomas has been proven to be associated with factors like extent of resection and grade of tumor. Decrease in progesterone receptor expression has been linked to increased rate of recurrence. We undertook this study to know about progesterone and estrogen receptor expression in meningiomas and its association with different clinicopathological variables as data is lacking in the Indian population.

Materials and Methods: Meningiomas operated in a tertiary referral centre of North Kerala, India in 2 years were taken into the study. The tumors were graded and immunohistochemistry was performed using antibodies to Estrogen and progesterone receptors (ER&PR) and Ki-67. The expression of PR and ER was correlated with clinicopathologic variables. The patients were followed up for 2 years.

Results: Grade I and grade II tumors constituted 85.3% and 14.7% respectively of the total number of meningioma cases. There were no grade III tumors in the series. The average PR positivity in grade I tumors (60.77%) was higher than in grade II tumors (46.88%). There was no gender related difference in PR staining. ER positivity was found only in a few cases.

Conclusion: PR deterioration was associated with increased cell turnover. Meningiomas occurring in this study population are similar in clinicopathological parameters to those tumors occurring in other parts of the country but different in some aspects like grade from tumors occurring in other parts of the world. Strict follow up of a larger cohort of patients for a longer time period will be required to draw conclusions about prognosis in this population.


Perry A, Louis DN, Scheithauer BW, Budka H, von Deimling: Meningiomas. In: Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (eds), WHO Classification of Tumors of the Central Nervous System. Lyon: IARC, 2007: 164-172.

Wolfsberger S, Doostkam S, Boecher-Schwarz HG, Roessler K, van Trotsenburg M, Hainfellner JA, Knosp E. Progesterone-receptor index in meningiomas: correlation with clinico-pathological parameters and review of the literature. Neurosurg Rev 2004; 27: 238-245.

Pravdenkova SV, Al-Mefty O, Sawyer JR, Husain MM. Progesterone and estrogen receptors: opposing prognostic indicators in meningiomas. Journal of neurosurgery, 2006; 105(2): 163-73.

Bernat AL, Oyama K, Hamdi S, et al. Growth stabilization and regression of meningiomas after discontinuation of cyproterone acetate: a case series of 12 patients. Acta Neurochir (Wien). 2015; 157(10): 1741-1746.

Grunberg SM, Weiss MH, Russell CA, Spitz IM, Ahmadi J, Sadun A, Sitruk-Ware R. Long-term administration of mifepristone (RU486): clinical tolerance during extended treatment of meningioma.Cancer Invest 2006; 24: 727-733.

Lamberts SW, Tanghe HL, Avezaat CJ, Braakman R, Wijngaarde R, Koper J W, and Jong H de. Mifepristone (RU 486) treatment of meningiomas. J Neurol Neurosurg Psychiatry 1992; 55: 486-490.

Touat M, Lombardi G, Farina P, Kalamarides M, Sanson M. Successful treatment of multiple intracranial meningiomas with the antiprogesterone receptor agent mifepristone (RU486). Acta Neurochir (Wien) 2014; 156: 1831-1835.

Cahill DW, Bashirelahi N, Solomon LW, Dalton T, Salcman M. Ducker TB. Estrogen and progesterone receptors in meningiomas, Journal of Neurosurgery 1984; 60(5): 985-993.

Fakhrjou A, Meshkini A, Shadrvan S. Status of Ki-67, estrogen and progesterone receptors in various subtypes of intracranial meningiomas. Pak J Biol Sci 2012; 15: 530-535.

Hernández Faraco A, Céspedes G, Trejo E. Immunohistochemical expression of progesterone receptor in relationship with histological grade and risk of relapses in intracranial meningiomas. Neurologia 2009; 24: 235-243.

Shayanfar N, Mashayekh M, Mohammadpour M. Expression of progestrone receptor and proliferative marker ki 67 in various grades of meningioma. Acta Med Iran 2010; 48: 142-147.

Tao Y1, Liang G, Li Z, Wang Y, Wu A, Wang H, Lu Y, Liu Z, Hu G. Clinical features and immunohistochemical expression levels of androgen, estrogen, progesterone and Ki-67 receptors in relationship with gross-total resected meningiomas relapse. Br J Neurosurg 2012; 26: 700-704.

Joseph E, Sandhyamani S, Rao MB, Nair S, Radhakrishnan VV. Atypical meningioma: A clinicopathologic analysis. Neurol India 2000; 48: 338-342.

Babu S, Uppin SG, Uppin MS, Panigrahi MK, Saradhi V, Bhattacharjee S, Sahu BP, Purohit AK, Challa S. Meningiomas: correlation of Ki67 with histological grade. Neurol India 2011; 59: 204-7.

Korhonen K, Salminen T, Raitanen J, Auvinen A, Isola J, Haapasalo H. Female predominance in meningiomas cannot be explained by differences in progesterone, estrogen or androgen receptor expression. J Neurooncol 2006; 80: 1-7.

Mukherjee S, Ghosh SN, Chatterjee U, Chatterjee S. Detection of progesterone receptor and the correlation with Ki-67 labeling index in meningiomas. Neurol India 2011; 59: 817-822.

Roser F, Samii M, Ostertag H, Bellinzona M. The Ki-67 proliferation antigen in meningiomas. Experience in 600 cases. Acta Neurochir (Wien) 2004; 146: 37-44.

Kumar S, Kakkar A, Suri V, Kumar A, Bhagat U, Sharma MC, Singh M, Suri A, Sarkar C. Evaluation of 1p and 14q status, MIB-1 labeling index and progesterone receptor immunoexpression in meningiomas: Adjuncts to histopathological grading and predictors of aggressive behavior. Neurol India 2014; 62: 376-82.

Omulecka A, Papierz W, Nawrocka-Kunecka A, Lewy-Trenda I. Immunohistochemical expression of progesterone and estrogen receptors in meningiomas. Folia Neuropathol 2006; 44: 111-115.

Zhou P, Ma W, Yin S, Li Y, Jiang S. Three risk factors for WHO grade II and III meningiomas: A study of 1737 cases from a single center. Neurol India 2013; 6: 40-44.

N Shahane S. Estrogen and progesterone receptor status in meningioma and its correlation with mib-1 labeling index. Indian J Neurosci 2019; 5(4): 232-235.

Telugu RB, Chowhan AK, Rukmangadha N, Patnayak R, Phaneendra BV, Mowliswara Prasad BC, Reddy MK. Estrogen and progesterone receptor in meningiomas: An immunohistochemical analysis. J Cancer Res Ther. 2020; 16(6): 1482-1487.

Iplikcioglu AC, Hatiboglu MA, Ozek E, Ozcan D. Is progesterone receptor status really a prognostic factor for intracranial meningiomas? Clin Neurol Neurosurg 2014; 124: 119-122.

Blankenstein MA, Verheijen FM, Jacobs JM, Donker TH, van Duijnhoven MW, Thijssen JH. Occurrence, regulation and significance of progesterone receptors in human meningioma. Steroids 2000; 65: 795-800.




How to Cite

Govindan, A., & Alapatt, J. P. (2023). Progesterone and Estrogen Receptors in Meningiomas – A Clinicopathological Analysis. Journal of Cancer Research Updates, 12, 10–15.