<![CDATA[Background: Meningioma is a common benign intracranial tumor originating from arachnoid cap cells and accounts for approximately one-third of all primary brain tumors. Its higher incidence in women suggests hormonal involvement, particularly from progesterone and progestogen exposure. Prolonged use of hormonal contraceptives, such as depo medroxyprogesterone acetate (DMPA), has been associated with the development and progression of meningioma. Objective: To describe the clinical presentation, neuroimaging findings, management, and possible association between long-term progesterone exposure and intracranial meningioma in a middle-aged woman. Methods: We report the case of a 44-year-old woman with a history of long-term DMPA use who presented with progressive neurological symptoms. Clinical evaluation, neuroimaging studies, surgical treatment, and histopathological examination were performed and reviewed. Results: The patient presented with recurrent severe headache, blurred vision, and a progressively enlarging right-sided scalp mass. She had received DMPA injections for more than 15 years. Contrast-enhanced brain CT demonstrated a well-defined right frontotemporal extra-axial mass consistent with meningioma. The patient subsequently underwent craniotomy and complete tumor excision. Histopathological examination confirmed a WHO Grade I meningioma with mixed meningothelial and angiomatous patterns. Conclusion: This case highlights a potential association between prolonged DMPA exposure and intracranial meningioma. Early recognition of neurological symptoms, timely neuroimaging evaluation, and appropriate surgical management are essential to optimize outcomes. Discontinuation of hormonal exposure should also be considered in patients with hormone-sensitive meningiomas.]]>
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