Pineal parenchymal tumors: Clinical, pathologic, and therapeutic aspects

Schild, Steven E.; Scheithauer, Bernd W.; Schomberg, Paula J.; Hook, C. Christopher; Kelly, Patrick J.; Frick, Rainer; Robinow, Jay S.; Buskirk, Steven J.

doi:10.1002/1097-0142(19930801)72:3<870::aid-cncr2820720336>3.0.co;2-x

Cited by 218 publications

(122 citation statements)

References 18 publications

(5 reference statements)

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“…3,33) A two-tiered staging system distinguishes pineoblastomas from pineocytomas. The pineocytoma is a well-circumscribed tumor that grossly compresses the surrounding tissue.…”

Section: Discussion I Histopathologymentioning

confidence: 99%

“…Mitosis are found along with Homer-Wright rosettes, Flexner-Wintersteiner rosettes, and areas of necrosis. 3,33) More recently, Schild et al 33) has divided pineal parenchymal tumors into four types: pineocytomas, intermediate tumors, mixed tumors, and pineoblastomas. The intermediate tumor is described as a transitional form between pineocytomas and pineoblastomas.…”

Section: Discussion I Histopathologymentioning

confidence: 99%

“…Using a grading scale for pineal parenchymal tumors based on number of mitoses, Fauchon et al 13) reported a median survival time of 38 months and 16 months for adult and pediatric patients with the higher grade tumors (grades 3 and 4), respectively. Schild et al 33) reported a 5-year survival rate of 58% for the 21 adult and pediatric patients with mixed, intermediate, or pure pineoblastomas. If the intermediate grade tumors are removed from Schild's or Fauchon's analysis, the survival rates remain poor.…”

Section: Survivalmentioning

confidence: 99%

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Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

Lee

Wakabayashi

Yoshida

2005

Neurol. Med. Chir.(Tokyo)

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Pineoblastoma is a rare tumor in adults, and factors influencing survival are poorly understood. Data from the Brain Tumor Registry of Japan (BTRJ) was analyzed to examine patient, tumor, and treatment characteristics associated with increased survival in adults with pineoblastomas. All pineoblastoma cases in adults aged 16 years or older were identified in the BTRJ. Data were extracted on demographics, presentation, tumor characteristics, treatments, and outcomes. Kaplan-Meier plots, the log rank method, and p value º0.15 was used to screen variables for inclusion in a multivariate Cox regression estimating survival. In the final Cox multivariate model, all variables with p values º0.05 were considered significant predictors of survival, and all variables with p values 0.05-0.099 were considered trends. The BTRJ contained 34 adults with pineoblastomas diagnosed from 1969-1998. The patients were predominantly male (22 patients), with a median age of 35 years (range 16-66 years). Median survival from diagnosis was 25.7 months, with a median follow up of 20.5 months. Median surgical resection was 75-94%, and five of the 34 patients had gross total resection. Twenty-nine of the 34 patients received cranial irradiation therapy with a median dose of 50 Gy (range 30-70 Gy). In the final multivariate model, cranial irradiation AE40 Gy (p ＝ 0.014) and gross total resection (p ＝ 0.034) were associated with improved survival. There was a trend towards improved survival for women (p ＝ 0.099). Adult pineoblastoma patients have poor survival prognosis. Cranial irradiation therapy using at least 40 Gy and complete surgical resection are associated with improved survival.

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“…3,33) A two-tiered staging system distinguishes pineoblastomas from pineocytomas. The pineocytoma is a well-circumscribed tumor that grossly compresses the surrounding tissue.…”

Section: Discussion I Histopathologymentioning

confidence: 99%

Section: Discussion I Histopathologymentioning

confidence: 99%

Section: Survivalmentioning

confidence: 99%

See 1 more Smart Citation

Management and Survival of Pineoblastoma: An Analysis of 34 Adults From the Brain Tumor Registry of Japan

Lee

Wakabayashi

Yoshida

2005

Neurol. Med. Chir.(Tokyo)

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“…The cells contain hyperchromatic round or oval nuclei and scanty cytoplasm and are usually arranged in Homer-Wright rosettes, widely considered to represent abortive attempts at neuroblastic differentiation (6). Mitosis is frequently observed along with rosettes and areas of necrosis (11). In addition, the tumor cells typically demonstrate immunoreactivity for neuronal markers, such as neurofilament, synaptophysin, chromogranin A, glial fibrillary acidic protein and S-100 protein.…”

Section: A B C D E F G Hmentioning

confidence: 99%

Complete regression of adult pineoblastoma following radiotherapy: A case report and review of the literature

Peng

Jiang

et al. 2015

Oncology Letters

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Abstract. Adult pineoblastomas (PBs) are rare central nervous system tumors. Little is known with regard to the clinical features and outcomes of adult PB, and optimal treatment strategies for adult PB remain to be determined. The current report describes a case of PB in a 46-year-old male, who presented with obstructive hydrocephalus due to a large pineal region mass. Considering the potential effect on quality of life, the patient underwent a partial resection. Postoperative radiotherapy, comprising prophylactic craniospinal irradiation at a dose of 34.2 Gy followed by a local 25.3-Gy 'boost' to the tumor site for a total dose of 59.5 Gy, resulted in the complete regression of the tumor without neurological deficits. The patient has remained free of recurrence for 36 months after radiotherapy. This case highlights a minimally invasive strategy to treat a rare pineal region tumor with significant involvement of critical structures that resulted in a favorable response and an excellent neurological outcome. The radiographic and histopathological features of PB are also reviewed, and the various treatment options reported in the literature are discussed. IntroductionPineal region tumors, which account for <1% of intracranial tumors (1), encompass a heterogeneous group of neoplasms that may be divided into four main categories: Germ cell tumors, glial cell tumors, pineal parenchymal tumors (PPTs) and other miscellaneous tumors and cysts. PPTs originate from cells in the pineal gland called pinealocytes, and represent only 0.3% of all primary tumors of the central nervous system (2). The current World Health Organization classification of PPTs includes well-differentiated pineocytoma (PC), PPT of intermediate differentiation and poorly differentiated pineoblastoma (PB) (3).PB is more common in children than in adults. It has been reported that the peak incidence of PB occurs in the first 4 years of life, with tendency to arise in the first and second decades (4). In addition, adult cases of PB account for <10% of published cases (5). Due to the rarity of PB, relevant data is limited, particularly regarding PB in adults. Thus, the biology, standard management and prognosis of PB are not well understood at present.The current report describes a case of PB occurring in a 46-year-old male who presented with obstructive hydrocephalus due to a large pineal region mass. This case highlights a minimally invasive strategy to treat a rare pineal region tumor with significant involvement of critical structures in an adult. Written informed consent was obtained from the patient. Case reportA 46-year old male was admitted to West China Hospital of West China Medical School (Sichuan University, Chengdu, China) in June 2011 with a 3-month history of mild headache, dizziness and impaired vision. No abnormalities were observed upon physical examination and laboratory tests. An ophthalmological exam revealed no evidence of papilledema.Computed tomography (CT) of the brain was performed, and a solid mass measuring 5 cm in diameter wa...

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“…Pinealoblastomas are embryonal CNS tumors described earlier. Pineocytomas are "mature" parenchymal cell neoplasms, which are rare in children, clinically benign in adolescents but potentially malignant in younger children (70). The differential diagnosis for suprasellar tumors is also rather broad, including astrocytomas and craniopharyngiomas (together, more than 80% of lesions in this location) as well as GCTs.…”

Section: Intracranial Germ Cell Tumorsmentioning

confidence: 99%