Pineal Gland Tumours - Our Experience at Tertiary Care Centre: A 3-Year Study

Abstract

BACKGROUND Pineal gland tumours are slow growing tumours arising in the pineal gland that resemble normal pineal gland. In WHO classification, they are considered as WHO Grade 1 tumours. Incidence of these tumours is very low. The germ cell tumours in this region are much more common arising from the pluripotent germ cells mistakenly lodged in this region during embryogenesis. Tumours which arise from the stroma are Gliomas and Atypical Teratoid Rhabdoid Tumours (ATRT). Commonest clinical presentation is hydrocephalus due to compression of tectum and upward gaze due to compression of superior colliculi. Radiology aids in giving a provisional diagnosis on CT and MRI. Confirmation with histopathology is important for proper treatment and prognosis. MATERIALS AND METHODS We present a retrospective study done over 3 years at a tertiary care centre. Radiologically diagnosed cases as pineal gland tumours, which were well demarcated within the region of pineal gland were included in the study. The surgically resected specimen were examined by squash cytology and then processed routinely for histopathology and immunohistochemistry. RESULTS AND CONCLUSION A total of 18 cases were studied and analysed. The lesions encountered were germ cell tumours, pineal parenchymal tumours and gliomas. On intraoperative squash, one case, which was diagnosed as glioma was later reported as Pineocytoma on histopathology and immunohistochemistry. Histological subtypes of pineal gland tumours on comparison with SEER database was correlated with our study. CONCLUSION Though pineal gland is a very small organ also considered as vestigial organ in lower primates the tumours present aggressively and are proved to be fatal except pineocytomas, which have a good prognosis with 5 year survival rate of 60 to 75% and hence exact diagnosis is critical to choose correct therapy.