Development of a symptomatic intracranial meningioma in a male-to-female transsexual after initiation of hormone therapy

Transsexual patients are routinely treated with sex hormone therapy, which may be a risk factor for meningiomas, although the data are largely inconclusive. Here we describe a male-to-female transsexual patient treated with estradiol patches, who developed an occipital meningioma causing generalized seizures. This is the second report of a male-to-female transsexual patient who developed a symptomatic meningioma after sex hormone treatment, adding to the growing evidence that sex hormones contribute to the pathogenesis of meningiomas. Meningiomas may therefore complicate hormone therapy and sex hormones may be contraindicated in transsexual candidates with meningiomas identified upon screening.