schwannoma & pregnancy

[krbonner]

Interesting thread.  I was just diagnosed last month with a 3.5 cm left AN after having had my second baby in Feb 2005.  (My first was born in April 2002).  I developed a sudden hearing loss and dizziness at 5 months pregnant, and was told it was a "pregnancy thing."  Unfortunately, the hearing loss didn't go away after giving birth though the dizziness did. 

-Katie

[maryballard]

Russ,
I'm not sure what research is out there that you are referring to, but I've had three different specialists, one from the House Institute, all tell me that there is no evidence to support the notion that these types of tumors grow more rapidly during pregnancy.

It is my understanding based on these conversations that there are two factors during pregnancy that contribute to rapid tumor growth -- increased blood flow and growth hormones. Since schwannomas aren't blood fed and don't have hormone receptors, there is no reason why pregnancy would cause more rapid growth.

My tumor has not changed in size since diagnosis, and is not big enough to warrant treatment so I went ahead with my pregnancy. I am almost 4 months along and so far my tumor symptoms have not changed. We'll see what happens, but I feel pretty confident in these three independent opinions.

Thanks!
Mary

[jamie]

Hi Mary, here is a study regarding hormone receptors and AN's.....


Acoustic neuromas are more frequent, larger, and more vascular in women, and their growth rate increases during pregnancy. Estrogen receptors were claimed to be demonstrated in these neoplasms for the first time in 1981. Since then, numerous diverging studies, using various biochemical and histochemical methods, have been published on the contents of estrogen and progesterone receptors in acoustic neuromas. We determined the content of estrogen and progesterone receptors by means of an immunohistochemical method, using monoclonal antibodies, which has proved to be reliable, reasonably sensitive, and clinically relevant in other tissues, especially in breast carcinomas. No estrogen or progesterone receptors could be found in 18 consecutive acoustic neuromas from 7 men and 11 women, ranging in age from 26 to 73 years. The results do not support preoperative hormone treatment of acoustic neuromas.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2297415&dopt=Abstract

The study seems contradictive to me, I wonder what they think causes rapid growth during pregnancy? 

[jamie]

Actually, found another one that seems more clear....


For a long time, it has been speculated that pregnancy stimulates the growth of acoustic schwannomas. To test this hypothesis, immunohistochemical stains for estrogen receptor, progesterone receptor, and proliferating cell nuclear antigen (PCNA) were performed. Flow cytometric studies for DNA ploidy and S-phase fraction determinations were also performed. The study subjects included 6 female patients with unilateral acoustic tumors; at the time of tumor removal, 1 woman was pregnant and the other 5 women were 2 to 10 months postpartum. The age-sex-matched control group consisted of 6 men and 12 nonpregnant women, all with acoustic schwannomas similar in size to those of the study group. The study found no statistically significant association between the presence or quantity of estrogen or progesterone receptors and pregnancy, DNA ploidy, proliferation indices, or clinical data. Based on PCNA indices, large tumors tended to be less "biologically active" than small lesions (P < .01). The authors concluded that pregnancy does not significantly stimulate the cellular growth of acoustic schwannomas.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7603272&dopt=Abstract

[maryballard]

Thanks Russ, this is really interesting. Does seem like there is contradictory evidence, and definitely different experiences among the women in this discussion.

[maryballard]

Sorry Jamie, i didn't look carefully at who posted these....
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Smiley
this info is in line with what my doctors seemed to think, that the evidence is weak at best to support the connection, though it doesn't explain the experiences of the women here...

i suppose it's a tough thing to study considering the infrequency.

[jenifyer]

I am very glad to read the post that supports no connection with rapid growth of AN and pregnancy.  I am just wondering what happened in my case though.  Supposedly these tumors grow very slowly.  In 2000 i had my first tumor removed and it was maybe 1 cm.  In 2005 after 2 pregnancies i found out it had reoccured and was over 3 cm.  If these grow so slowly, why did mine grow back so fast?  I did have the second sugery and am very happy with how things have turned out.  I am concerned if i want to have another baby though, what would happen.....

jennifer