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Mitogen-activated protein kinase 3 (MAPK3) and human epidermal growth factor receptor 2 (HER2) on recurrent intracranial meningiomas: a case report

  • Ridha Dharmajaya ,
  • Abdurrahman Mouza ,


Introduction. Meningiomas accounts for one-third of all adult central nervous system tumors and by far the most common primary intracranial tumor in adults. Despite their high prevalence, it remains challenging to predict their biological and clinical behavior. To date, it has been accepted that the extent of surgical resection and histological grade are the most reliable factors to predict the recurrence of meningiomas. HER2 and MAPK3 represent a well-known prognostic factor in various tumors, however only a few studies on the relationship between meningioma recurrence, HER2, and MAPK3 expression. This report presents additional data that support the relationship between the expression HER2 and MAPK3 with recurrent of meningioma.

Case: We report 39 years-old-female with recurrent meningioma. The patient had tumor removal a year ago. After the first resection, the tumor demonstrated rapid growth with significant invasion to neighboring dural tissue and brain parenchyma, which resulted in impaired brain function and intracranial hypertension manifested as severe headache, vomiting, and coma. Histopathological examination confirms a malignant meningioma (WHO grade I). The patient had the second craniotomy for tumor removal, and we performed immunohistochemical staining. The result was positive for HER2 and MAPK3

Conclusion: HER2 and MAPK3 might be a reliable predictor of recurrent meningiomas.



  1. Shibuya M. Pathology and Molecular Genetics of Meningioma: Recent Advances. Neurol Med Chir (Tokyo). 2015;55 Suppl 1:14–27.
  2. Boldrey E., Minckler J. The meningiomas. In: Pathology of the Nervous System. New York: Mc Graw Hill; 1971. p. 2125–44.
  3. Gupta P.K., Sastry Kolluri V.R., Das S., Chandra Mouli B.A., Narayana Swamy K.S., Das B.S. Recurrences in meningioma after surgery. Acta Neurochir (Wien). 1989;100(3–4):104–7.
  4. Perry A., Stafford S.L., Scheithauer B.W., Suman V.J., Lohse C.M. Meningioma grading: an analysis of histologic parameters. Am J Surg Pathol. 1997;21(12):1455–65.
  5. Adegbite A.B., Khan M.I., Paine K.W.E., Tan L.K. The recurrence of intracranial meningiomas after surgical treatment. J Neurosurg. 1983;58(1):51–6.
  6. Mahmood A., Qureshi N.H., Malik G.M. Intracranial meningiomas: analysis of recurrence after surgical treatment. Acta Neurochir (Wien). 1994;126(2–4):53–8.
  7. Mahzouni P., Movahedipour M. An immunohistochemical study of HER2 expression in meningioma and its correlation with tumor grade. Pathol Res Pract. 2012;208(4):221–4.
  8. Schwechheimer K., Läufle R.M., Schmahl W., Knödlseder M., Fischer H., Höfler H. Expression of neu/c-erbB-2 in human brain tumors. Hum Pathol. 1994;25(8):772–80.
  9. Wang W., Tu Y., Wang S., Xu S., Xu L., Xiong Y., et al. Role of HER-2 activity in the regulation of malignant meningioma cell proliferation and motility. Mol Med Rep. 2015;12(3):3575–82.
  10. Mirimanoff R.O., Dosoretz D.E., Linggood R.M., Ojemann R.G., Martuza R.L. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg. 1985;62(1):18–24.
  11. Nakasu S., Nakasu Y., Nakajima M., Matsuda M., Handa J. Preoperative identification of meningiomas that are highly likely to recur. J Neurosurg. 1999;90(3):455–62.
  12. Cossu G., Messere M., Parker F., Levivier M., Daniel R.T. Meningiomas’ Management: An Update of the Literature. Neurooncology Newer Dev. 2016;15:361–79.
  13. David N. The 2007 WHO Classification of Tumours of the Central Nervous System. Acta Neuropathol. 2007;114:97–109.
  14. Mason W.P., Gentili F., Macdonald D.R., Hariharan S., Cruz C.R., Abrey L.E. Stabilization of disease progression by hydroxyurea in patients with recurrent or unresectable meningioma. J Neurosurg. 2002;97(2):341–6.
  15. Mattozo C.A., De Salles A.A.F., Klement I.A., Gorgulho A., McArthur D., Ford J.M., et al. Stereotactic radiation treatment for recurrent nonbenign meningiomas. J Neurosurg. 2007;106(5):846–54.
  16. Whittle I.R., Smith C., Navoo P., Collie D. Meningiomas. Lancet (London, England). 2004;363(9420):1535–43.
  17. Wang Z., Wang W., Xu S., Wang S., Tu Y., Xiong Y., et al. The role of MAPK signaling pathway in the Her-2-positive meningiomas. Oncol Rep. 2016;36(2):685–95.
  18. Chozick B.S., Benzil D.L., Stopa E.G., Pezzullo J.C., Knuckey N.W., Epstein M.H., et al. Immunohistochemical evaluation of erbB-2 and p53 protein expression in benign and atypical human meningiomas. J Neurooncol. 1996;27(2):117–26.
  19. Tai W., Mahato R., Cheng K. The role of HER2 in cancer therapy and targeted drug delivery. J Control Release. 2010;146(3):264–75.
  20. Mitri Z., Constantine T., O’Regan R. The HER2 Receptor in Breast Cancer: Pathophysiology, Clinical Use, and New Advances in Therapy. Chemother Res Pract. 2012;2012:1–7.
  21. Wang C., Mei J., Wang S., Xu S., Xu L., Xiong Y. [Expression of HER2/neu in meningiomas: an immunohistochemistry and fluorescence in situ hybridization study]. Zhonghua bing li xue za zhi = Chinese J Pathol. 2010;39(3):156–60.
  22. Torp S.H., Helseth E., Unsgaard G., Dalen A. C-erbB-2/HER-2 protein in human intracranial tumours. Eur J Cancer. 1993;29A(11):1604–6.
  23. Andersson U., Guo D., Malmer B., Bergenheim A.T., Brännström T., Hedman H., et al. Epidermal growth factor receptor family (EGFR, ErbB2-4) in gliomas and meningiomas. Acta Neuropathol. 2004;108(2):135–42.
  24. Potti A., Panwalkar A., Langness E., Sholes K., Tendulkar K., Chittajalu S., et al. Role of her-2/neu overexpression and clinical features at presentation as predictive factors in meningiomas. Am J Clin Oncol. 2004;27(5):452–6.
  25. Loussouarn D., Brunon J., Avet-Loiseau H., Campone M., Mosnier J.-F. Prognostic value of HER2 expression in meningiomas: an immunohistochemical and fluorescence in situ hybridization study. Hum Pathol. 2006;37(4):415–21.
  26. Alessi D.R., Saito Y., Campbell D.G., Cohen P., Sithanandam G., Rapp U., et al. Identification of the sites in MAP kinase kinase-1 phosphorylated by p74raf-1. EMBO J. 1994;13(7):1610–9.
  27. Cain S.A., Smoll N.R., Van Heerden J., Tsui A., Drummond K.J. Atypical and malignant meningiomas: Considerations for treatment and efficacy of radiotherapy. J Clin Neurosci. 2015;22(11):1742–8.
  28. Butch E.R., Guan K.L. Characterization of ERK1 activation site mutants and the effect on recognition by MEK1 and MEK2. J Biol Chem. 1996;271(8):4230–5.

How to Cite

Dharmajaya, R., & Mouza, A. (2019). Mitogen-activated protein kinase 3 (MAPK3) and human epidermal growth factor receptor 2 (HER2) on recurrent intracranial meningiomas: a case report. Bali Medical Journal, 8(3), 749–752.




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