Pattern of Intracranial Meningiomas Associated With Prolonged DMPA Use: Systematic Review of Synthetic Progestins and Case Series of DMPA-Associated Intracranial Meningiomas

Hussam Abou-Al-Shaar; Rachel Wrigley; Thibault Passeri; Anthony Tang; Ibrahem Albalkhi; Samuel Adida; Aneek Patel; Arka N. Mallela; Georgios A. Zenonos; Paul A. Gardner

doi:10.1227/neu.0000000000004031

April 21, 2026Neurosurgery

Pattern of Intracranial Meningiomas Associated With Prolonged DMPA Use: Systematic Review of Synthetic Progestins and Case Series of DMPA-Associated Intracranial Meningiomas

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Key Points

This research aims to explore the connection between prolonged DMPA (depot medroxyprogesterone acetate) use and the development of intracranial meningiomas.
Conducted a systematic review of existing literature on synthetic progestins and their association with meningiomas.
Analyzed case series of patients with DMPA-associated intracranial meningiomas.
Reviewed patterns of lesion presentation and recommendations for treatment.
Identified a distinct pattern of multiple, bone-invasive, PR-positive meningiomas in long-term DMPA users.
Suggests that asymptomatic lesions offer the possibility of drug discontinuation and observation before surgical intervention.
Indicates potential need for prospective validation of these findings.

Implication

Systematic review finds distinct patterns of meningiomas in those using DMPA, suggesting observation before surgery.

Abstract

Long-term DMPA use is associated with a distinct pattern of multiple, bone-invasive, PR-positive meningiomas. Based on established patterns with other progestins, drug discontinuation and observation before surgical intervention should be considered for asymptomatic lesions, although prospective validation is warranted.

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Cite This Study

Abou-Al-Shaar et al. (2026) studied this question.

synapsesocial.com/papers/69e9b91385696592c86ec09e https://doi.org/10.1227/neu.0000000000004031

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Pattern of Intracranial Meningiomas Associated With Prolonged DMPA Use: Systematic Review of Synthetic Progestins and Case Series of DMPA-Associated Intracranial Meningiomas

Key Points

Implication

Abstract

Discussion

Cite This Study

Pattern of Intracranial Meningiomas Associated With Prolonged DMPA Use: Systematic Review of Synthetic Progestins and Case Series of DMPA-Associated Intracranial Meningiomas

Key Points

Implication

Abstract

Discussion

Cite This Study

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