2411_2 - correspondence Dr. Farooki reports receiving...

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correspondence n engl j med 357;23 www.nejm.org december 6, 2007 2411 Dr. Farooki reports receiving speaking fees from Procter & Gamble and Novartis. No other potential conflict of interest relevant to this letter was reported. Canalis E, Giustina A, Bilezikian JP. Mechanisms of ana- bolic therapies for osteoporosis. N Engl J Med 2007;357:905-16. Cote RJ, Beattie EJ, Chaiwun B, et al. Detection of occult bone marrow micrometastases in patients with operable lung carcinoma. Ann Surg 1995;222:415-25. 1. 2. Braun S, Vogl FD, Naume B, et al. A pooled analysis of bone marrow micrometastasis in breast cancer. N Engl J Med 2005; 353:793-802. Whitfield JF. Parathyroid hormone: a novel tool for treating bone marrow depletion in cancer patients caused by chemo- therapeutic drugs and ionizing radiation. Cancer Lett 2006;244: 8-15. Scadden DT. The stem cell niche in health and leukemic disease. Best Pract Res Clin Haematol 2007;20:19-27. 3. 4. 5. Growth of a Meningioma in a Transsexual Patient after Estrogen–Progestin Therapy To the Editor: A 28-year-old male-to-female transsexual patient presented with severe headache and visual disturbances; clinical examination showed visual impairment, with bitemporal infe- rior visual-field defects, papilledema of the left eye, and optic atrophy of the right eye. The patient was euphoric and confused. Personality changes noted during the previous 4 months had been at- A B C D Figure 1. MRI Scans and Histologic Findings. Panel A shows a sagittal contrast-enhanced MRI scan obtained for screening for hyperprolactinemia, and Panel B a sagittal contrast-enhanced MRI scan showing a giant olfactory-groove meningioma in the same patient after a high-dose estrogen–progestin regimen for management of sex reassignment. Histologic analysis revealed a menin- gothelial meningioma (World Health Organization grade I) with a Ki-67 index of 5%, shown in Panel C, and an
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2411_2 - correspondence Dr. Farooki reports receiving...

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