SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
This article is part of the Research TopicAdvances in Meningioma Management and Treatment: Novel Diagnostic Approaches and Emerging Therapeutic StrategiesView all 3 articles
Association of hormone therapy with spheno-orbital meningiomas: bridging evidence and unknowns
Provisionally accepted
- Division of Neurological Surgery, Barrow Neurological Institute (BNI), Phoenix, Arizona, United States
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Objective: To evaluate the association between hormone therapy and the development, progression, and treatment response of spheno-orbital meningiomas (SOMs) and to identify current evidence gaps in clinical management. Methods: A systematic literature review was conducted using an advanced search of PubMed, Embase, Scopus, and Cochrane databases for articles published in English. The selection process adhered to the PRISMA guidelines. Inclusion criteria targeted original research published from inception to May 2025, which discussed hormone therapy exposure and SOMs. Study quality was assessed with Joanna Briggs Institute critical appraisal tools appropriate to each study design. Results: Twenty articles were retrieved. After screening, 10 studies met the inclusion criteria and were analyzed. The studies comprised 2 case reports, 1 prospective cohort, and 7 retrospective cohorts, totaling 315 patients with SOMs. The gender distribution was predominantly female (166 women, 4 men) in the 7 studies that reported mean age data for patients with SOM. The patients had a mean (SD) history of 12.6 (3.67) years of hormone therapy exposure, with 90% of the therapies being progestins. Six studies reported a decrease in the SOM volume after hormone therapy cessation, and 4 studies documented a decrease in the soft tissue component with progression or stabilization of the intraosseous component. The therapeutic goal was surgical resection. Subtotal resection was associated with higher recurrence than total resection, especially when the residual tumor included soft tissue. Conservative management, involving hormone therapy cessation, was reported in 3 cases. Data were limited regarding progesterone receptor status and the use of radiation therapy. Conclusions: Current evidence suggests that hormone therapy, particularly long-term exposure to progestins, may contribute to the development and progression of SOMs. Although cessation of hormone therapy can result in partial tumor regression, especially in soft tissue components, surgical resection remains the primary treatment. Hybrid strategies that combine hormone therapy cessation with surgery may be beneficial in selected cases, although prospective data are lacking. Standardized clinical guidelines and further studies are needed to clarify the role of hormone therapy in the management of SOM.
Keywords: Cyproterone Acetate, hormone therapy, Meningioma, progesteronereceptors, Skull base tumors, spheno-orbital meningioma, surgical oncology, tumorregression
Received: 09 Dec 2025; Accepted: 16 Feb 2026.
Copyright: © 2026 Prince, Yangi, Goyal, Qureshi, Olson, Gök and Preul. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mark Preul
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