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Endoscopic resection of thalamic lesions via supracerebellar infratentorial approach: a case series and technical note. Neurosurg Rev 2022; 45:3817-3827. [DOI: 10.1007/s10143-022-01891-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/05/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022]
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2
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Stecco A, Cavalieri S, Masini L, Krengli M, Cossandi C, Boldorini R, Carriero A. o-6-methylguanine-dna methyltransferase (mgmt)-metilated pineal glioblastoma in young women: report of two cases and literature review. J Neurosurg Sci 2021; 66:75-78. [PMID: 34114430 DOI: 10.23736/s0390-5616.21.05268-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alessandro Stecco
- Department of Diagnostic and Interventional Radiology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Sergio Cavalieri
- Department of Diagnostic and Interventional Radiology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy -
| | - Laura Masini
- Department of Radiation Oncology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Marco Krengli
- Department of Radiation Oncology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Christian Cossandi
- Department of Neurosurgery, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Renzo Boldorini
- Department of Histopathology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
| | - Alessandro Carriero
- Department of Diagnostic and Interventional Radiology, AOU Ospedale Maggiore della Carità di Novara, Novara, Italy
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Niu X, Wang C, Zhou X, Yang Y, Liu Y, Zhang Y, Mao Q. Pineal Region Glioblastomas: Clinical Characteristics, Treatment, and Survival Outcome. World Neurosurg 2020; 146:e799-e810. [PMID: 33186787 DOI: 10.1016/j.wneu.2020.11.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Given the rarity of patients with pineal glioblastoma (GBM), clinical characteristics, treatment, and prognostic factors are not well characterized. This study aimed to investigate these characteristics and identify the prognostic factors of overall survival (OS). METHODS A retrospective analysis of newly diagnosed patients with pineal GBM, including our 3 cases and an additional 44 cases from published articles, was conducted. Survival analysis was performed by Kaplan-Meier analysis and Cox regression analysis was used to determine the prognostic factors. RESULTS A total of 47 patients (28 males and 19 females) were enrolled, with a median age of 46 years (range, 5-74 years). Forty-four patients (90.9%) had preoperative obstructive hydrocephalus. Among 38 patients, 21 (55.3%) had distal leptomeningeal dissemination. Forty-five patients (95.7%) had resection/biopsy, 6 of whom had gross total resection, 22 had subtotal resection, 7 had partial resection, and 10 had biopsy. Adjuvant therapy included radiotherapy in 36 patients and chemotherapy in 27 patients. The median OS was 10.0 months. The 6-month, 1-year, and 2-year survival was 68.0%, 42.6%, and 17.0%, respectively. Cox regression analysis showed that patients receiving biopsy (P = 0.042) or chemotherapy (P = 0.029) had the better OS and these were regarded as independent prognostic factors. Further survival analysis showed that chemoradiotherapy had better survival benefit than other regimens. CONCLUSIONS In this study, we summarized the characteristics of patients with pineal GBM and showed the correlation between clinical characteristics and prognosis. This study may give readers a deep understanding of these rare GBMs and provide some references for future management.
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Affiliation(s)
- Xiaodong Niu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Chenghong Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xingwang Zhou
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Yuekang Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China.
| | - Qing Mao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China; West China Glioma Centre, West China Hospital, Sichuan University, Chengdu, China
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Yerneni K, Fatemi P, Vogel H, Li G, Zygourakis CC. Leptomeningeal spread with spinal involvement of pineal glioblastoma at initial presentation: A case report. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2019.100658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Sajan A, Hewitt K, Soleiman A, Velayudhan V. Pineal glioblastoma: Case report and literature review of an exceedingly rare etiology for pineal region mass. Clin Imaging 2019; 60:95-99. [PMID: 31865216 DOI: 10.1016/j.clinimag.2019.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/04/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
Pineal glioblastoma is an exceedingly rare potential etiology for a pineal region mass. The presentation, imaging appearance, and changes in treatment have been documented in a select number of cases since its first description in 1954. Through these cases, changes in treatment have shown to improve outcomes in select patients, some of which have had survival times over two or three years. We present a case of a 39 year old female with biopsy proven pineal glioblastoma who demonstrates improvement on imaging and survival >12 months after treatment with radiation therapy and chemotherapy. Our case and the prior reported cases enable future research into improving treatment, classification, and imaging recognition for this unlikely disease.
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Affiliation(s)
- Abin Sajan
- SUNY Downstate Health Sciences University, United States of America
| | - Kevin Hewitt
- SUNY Downstate Health Sciences University, United States of America.
| | - Aron Soleiman
- SUNY Downstate Health Sciences University, United States of America
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Choque-Velasquez J, Resendiz-Nieves J, Jahromi BR, Colasanti R, Raj R, Vehviläinen J, Tynninen O, Collan J, Niemelä M, Hernesniemi J. Extent of Resection and Long-Term Survival of Pineal Region Tumors in Helsinki Neurosurgery. World Neurosurg 2019; 131:e379-e391. [PMID: 31369883 DOI: 10.1016/j.wneu.2019.07.169] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pineal region tumors represent challenging surgical lesions with wide ranges of survival reported in different surgical series. In this article, we emphasize the role of complete microsurgical resection (CMR) to obtain a favorable long-term outcome of pineal region tumors. METHODS We report a retrospective study of pineal region tumors operated on in Helsinki Neurosurgery between 1997 and 2015. Information was obtained from the hospital records, and an evaluation of the Finnish population register was conducted in July 2018 to determine the current status of the patients. RESULTS A total of 76 pineal region tumors were operated on. The survival was 62% at a mean follow-up of 125 ± 105 months (range, 0-588 months), and the disease-related mortality was limited to 14 patients (18.4%). Up to July 2018, 29 patients had died. Two patients died 1 and 3 months after surgery of delayed thalamic infarctions, 12 patients of disease progression, and 15 had non-disease-related deaths. Only 1 patient was lost in the long-term follow-up. Ten of 14 disease-related deaths occurred during the first 5 years of follow-up: 5 diffuse gliomas, 3 germ cell tumors, 1 grade II-III pineal parenchymal tumor of intermediate differentiation, and 1 meningioma. CMR was linked to better tumor-free survival and long-term survival, with the exception of diffuse gliomas. CONCLUSIONS CMR, in the setting of a multidisciplinary management of pineal region tumors, correlates with favorable survival and with minimal mortality. Surgically treated grade II-IV gliomas constitute a particular group with high mortality within the first 5 years independently of the microsurgical resection.
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Affiliation(s)
- Joham Choque-Velasquez
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
| | - Julio Resendiz-Nieves
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Behnam Rezai Jahromi
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Roberto Colasanti
- Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy; Department of Neurosurgery, Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Rahul Raj
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Juho Vehviläinen
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Olli Tynninen
- Department of Pathology, University of Helsinki and HUSLAB, Helsinki University Hospital, Helsinki, Finland
| | - Juhani Collan
- Department of Radiation Oncology, Cancer Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Juha Hernesniemi
- "Juha Hernesniemi" International Center for Neurosurgery, Henan Provincial Peopleás Hospital, Zhengzhou, China
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D'Amico RS, Zanazzi G, Wu P, Canoll P, Bruce JN. Pineal region glioblastomas display features of diffuse midline and non-midline gliomas. J Neurooncol 2018; 140:63-73. [PMID: 29992434 DOI: 10.1007/s11060-018-2931-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/17/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Pineal region glioblastomas (GBM) are very rare, with approximately 46 cases described in the literature. The epidemiology, pathogenesis, and treatment of these lesions are poorly characterized. METHODS We identified all cases of pineal region GBM treated surgically at our institution between 1990 and 2017. Demographic and clinical follow-up data were extracted from the medical records for all cases. Pathology was reviewed and classified according to 2016 World Health Organization (WHO) criteria. Specific attention was given to the frequency of histone H3 K27M mutations in these midline gliomas. RESULTS Eight patients (seven men, one woman) with pineal region GBM, WHO grade IV, were identified. The most common presenting symptoms were headache (75%), vision changes (75%), and gait imbalance/ataxia (50%). Median age at diagnosis was 48.5 years (range 36-74 years). Radical subtotal resection, via a supracerebellar infratentorial approach, was achieved in 75% of patients. Review of the surgical pathology revealed seven primary GBMs (including one giant cell GBM) and one pineal region GBM that developed three years after resection of a pineal parenchymal tumor of intermediate differentiation. No cases demonstrated evidence of IDH-1 R132H mutation (N = 6) or 1p/19q co-deletion (N = 3). One case tested positive for the histone H3 K27M-mutation. Targeted exome sequencing of 467 cancer-related genes revealed nonsense mutations in ATRX and NF1. Adjuvant radiation and chemotherapy was employed in 87.5% and 75.0% of patients, respectively. Median overall survival (OS) was 15 months (range 2-24 months) from GBM diagnosis. CONCLUSIONS This study expands the clinical and pathologic spectrum of pineal region GBM, and provides the first report of the genetic landscape of these tumors.
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Affiliation(s)
- Randy S D'Amico
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
| | - George Zanazzi
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Peter Wu
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
| | - Peter Canoll
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA
| | - Jeffrey N Bruce
- Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA
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Orrego E, Casavilca S, Garcia-Corrochano P, Rojas-Meza S, Castillo M, Castaneda CA. Glioblastoma of pineal region: report of four cases and literature review. CNS Oncol 2017; 6:251-259. [PMID: 28990813 DOI: 10.2217/cns-2016-0047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report four cases of glioblastoma in the pineal region. The patients presented a severe headache and vomiting. Brain imaging showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. Case 3 developed a subependymal dissemination. The patient went to ventricular-peritoneal shunt and subtotal or total resection and radiotherapy with/without chemotherapy. Cases 1 and 2 received radiation and died 8 and 11 later months. Cases 3 and 4 completed radiotherapy and chemotherapy, and survived 28 and 31 months after the initial diagnosis. Glioblastoma in the pineal region carry a poor prognosis and require neurooncology teams.
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Affiliation(s)
- Enrique Orrego
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Sandro Casavilca
- Department of Pathology, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | | | - Sugey Rojas-Meza
- Department of Neurosurgery, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Miluska Castillo
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
| | - Carlos A Castaneda
- Research Department, Instituto Nacional de Enfermedades Neoplasicas, 15038 Lima, Peru
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Stowe HB, Miller CR, Wu J, Randazzo DM, Ju AW. Pineal Region Glioblastoma, a Case Report and Literature Review. Front Oncol 2017; 7:123. [PMID: 28660172 PMCID: PMC5466962 DOI: 10.3389/fonc.2017.00123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/26/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Pineal region glioblastoma multiforme (GBM) is a rare disease entity with a generally poor prognosis. We present a case of a patient with an unresectable pineal region GBM treated with chemoradiation with favorable outcome. Case background A 65-year-old patient who was presented with visual symptoms was found to have a pineal region tumor on imaging. A stereotactic biopsy showed a World Health Organization Grade IV GBM, O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylated, isocitrate dehydrogenase 1 and 2 wild type. The patient was treated with radiotherapy with concurrent temozolomide, followed by adjuvant temozolomide. Disease progression occurred at 58 weeks post-biopsy, which prompted the initiation of bevacizumab. The patient was alive and functioning well as of his last follow up, 166 weeks from the initial biopsy. Discussion On our review of the literature, 24 cases of pineal region GBM have been reported. The median reported survival for these previously reported cases was 6 months (range, 2–24 months). This patient has the longest overall survival reported to date for a patient with this diagnosis. This is the first patient in the literature with pineal region GBM who has been reported to have MGMT promoter methylation. Concluding remarks Although pineal region GBM is a rare disease entity with a generally poor prognosis, long-term survival is achievable for select patients. MGMT promoter methylation may potentially have prognostic value. Favorable control of recurrent disease with the use of bevacizumab is possible.
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Affiliation(s)
- Hayley Beacher Stowe
- Department of Radiation Oncology, Brody School of Medicine, Greenville, NC, United States
| | - C Ryan Miller
- Department of Pathology, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Jing Wu
- Center for Cancer Research National Cancer Institute, Bethesda, MD, United States
| | - Dina M Randazzo
- Department of Neuro-Oncology, Duke Health, Durham, NC, United States
| | - Andrew Wenhua Ju
- Department of Radiation Oncology, Brody School of Medicine, Greenville, NC, United States
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Nadvi SS, Timatkia K. Primary pineal glioblastoma multiforme mimicking a germ cell tumour. Br J Neurosurg 2016; 32:456-457. [DOI: 10.1080/02688697.2016.1265084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Syed Sameer Nadvi
- Department of Neurosurgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- St Augustine’s Hospital, Durban, South Africa
| | - Kritish Timatkia
- Department of Neurosurgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Matsuda R, Hironaka Y, Suigimoto T, Nakase H. Glioblastoma Multiforme in the Pineal Region with Leptomeningeal Dissemination and Lumbar Metastasis. J Korean Neurosurg Soc 2015; 58:479-82. [PMID: 26713151 PMCID: PMC4688320 DOI: 10.3340/jkns.2015.58.5.479] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 11/27/2022] Open
Abstract
We report a case of a 31-year-old woman with glioblastoma multiforme (GBM) in the pineal region with associated leptomeningeal dissemination and lumbar metastasis. The patient presented with severe headache and vomiting. Magnetic resonance imaging (MRI) of the brain showed a heterogeneously enhanced tumor in the pineal region with obstructive hydrocephalus. After an urgent ventricular-peritoneal shunt, she was treated by subtotal resection and chemotherapy concomitant with radiotherapy. Two months after surgery, MRI showed no changes in the residual tumor but leptomeningeal dissemination surrounding the brainstem. One month later, she exhibited severe lumbago and bilateral leg pain. Thoracico-lumbar MRI showed drop like metastasis in the lumbar region. Finally she died five months after the initial diagnosis. Neurosurgeons should pay attention to GBM in the pineal region, not only as an important differential diagnosis among the pineal tumors, but due to the aggressive features of leptomeningeal dissemination and spinal metastasis.
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Affiliation(s)
- Ryosuke Matsuda
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
| | - Yasuo Hironaka
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
| | - Tadashi Suigimoto
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
| | - Hiroyuki Nakase
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
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Miyaji Y, Yagishita S, Zhang N, Watanabe D, Miyasaki H, Mabuchi I, Taira S, Tanaka F. Obstructive hydrocephalus and leptomeningeal dissemination with an unknown primary lesion in a 67-year-old man. Neuropathology 2014; 34:596-601. [DOI: 10.1111/neup.12136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yosuke Miyaji
- Department of Neurology; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Saburo Yagishita
- Department of Pathology; Kanagawa Rehabilitation Center; Atsugi Japan
| | - Ning Zhang
- Department of Neurology; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Daisuke Watanabe
- Department of Neurology; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Hidetake Miyasaki
- Department of Neurology; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Ikki Mabuchi
- Department of Neurosurgery; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Sayoko Taira
- Department of Pathology; Chigasaki Municipal Hospital; Chigasaki Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine; Yokohama City University Graduate School of Medicine; Yokohama Japan
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Magrini S, Feletti A, Marton E, Longatti P. Gliomas of the pineal region. J Neurooncol 2013; 115:103-11. [PMID: 23820809 DOI: 10.1007/s11060-013-1200-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/27/2013] [Indexed: 10/26/2022]
Abstract
Although several series of pineal region tumors are available, the issue of pineal gliomas has been scarcely faced in the literature. Gliomas are usually included in largest series of pineal neoplasms. Therefore, whether pineal gliomas share the biological behavior of either hemispheric gliomas or other midline lesions is not yet defined. The aim of this retrospective study is to analyze long-term morbidity and mortality of these lesions. In English published literature gliomas account for about 14-22 % of all pineal region tumors. Most of these tumors are pilocytic astrocytomas, while glioblastoma multiforme is rare. We retrospectively analyzed all pineal region tumors operated on in our department in the last 28 years, and identified eight pineal astrocytomas, accounting for 14.03 % of all pineal tumors. The series includes four pilocytic astrocytomas, two grade II diffuse astrocytomas, and two anaplastic astrocytomas. A comprehensive review of the available literature data shows that the mean survival time of WHO grade II gliomas is shorter when tumor grows in the pineal region than for hemispheric locations, although the limited amount of available data prevents a rigorous statistical analysis. This difference might be due to the peculiar infiltrating behavior of pineal tumors, which often can't be satisfactorily resected from vital structures.
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Affiliation(s)
- Salima Magrini
- Department of Neurosurgery, Treviso Regional Hospital, University of Padova, Piazzale Ospedale 1, 31100, Treviso, Italy
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Kaloostian PE, Chen H, Tran HP. Malignant papillary glioneuronal tumor of the pineal gland: Case presentation and literature review of a distinct entity. AMERICAN JOURNAL OF CASE REPORTS 2013; 14:164-8. [PMID: 23826458 PMCID: PMC3700453 DOI: 10.12659/ajcr.883919] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/02/2013] [Indexed: 11/09/2022]
Abstract
Patient: Male, 58 Final Diagnosis: Papillary glioneuronal tumor of the pineal gland Symptoms: Headache • loss of memory • hydrocephalus Medication: — Clinical Procedure: — Specialty: Oncology • neurology • neurosurgery Objective: Rare disease Background: The authors report the third case of a rare papillary glioneuronal tumor of the pineal gland and only the second case reported with anaplastic features in this particular location. The authors also review the literature of papillary glioneuronal tumors. Case Report: Our patient is a 58-year-old Caucasian male who presented with diffuse headaches and loss of short-term memory. There were no deficits on physical exam. MRI Brain was performed demonstrating a large heterogeneously enhancing mass within the pineal gland causing obstructive hydrocephalus. He was taken to the operating room for supracerebellar-infratentorial approach for biopsy of the mass using neuronavigation. He required an endoscopic third ventriculostomy post-operatively for worsening hydrocephalus. Pathology demonstrated a rare malignant papillary glioneuronal tumor. It was recommended that patient undergo chemotherapy and radiation, however he refused treatment. He died six months after his initial diagnosis due to a condition unrelated to his intracranial tumor. Conclusions: This is an unusually rare tumor of the pineal gland, with only one other malignant case noted in this location. We review the literature of this rare entity that should be considered on the differential diagnosis of a pineal gland mass.
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Affiliation(s)
- Paul E Kaloostian
- University of New Mexico, Department of Neurosurgery, Albuquerque, NM, U.S.A
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Fèvre-Montange M, Vasiljevic A, Champier J, Jouvet A. Histopathology of tumors of the pineal region. Future Oncol 2010; 6:791-809. [PMID: 20465391 DOI: 10.2217/fon.10.28] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pineal region tumors are heterogeneous lesions and include mainly pineal parenchymal tumors (PPTs), papillary tumors of the pineal region (PTPRs) and germ cell tumors (GCTs). This article describes the cystic pineal gland compared with normal tissue and histopathological features of the most frequent pineal region tumors. PPTs are subdivided into pineocytoma (grade I), pineoblastoma (grade IV) and tumors with intermediate differentiation (PPTIDs; grades II-III). A grading system based on the number of mitoses and neurofilament protein expression distinguishes low- from high-grade PPTID. PTPR is a new tumoral entity thought to originate from the subcommissural organ. GCTs include germinoma, embryonal carcinoma, teratoma, yolk sac tumor and choriocarcinoma and are often of mixed histologic composition. New histogenetic data for GCTs are presented.
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Affiliation(s)
- Michelle Fèvre-Montange
- National Institute of Health & Medical Research (INSERM) U842, University of Lyon, Faculty of Medicine, RTH Laennec, Lyon Cedex 08, France.
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