Pineal region tumours in childhood

Drummond, Katharine J.; Rosenfeld, Jeffrey V.

doi:10.1007/s003810050347

Cited by 36 publications

(10 citation statements)

References 17 publications

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“…Endocrine symptoms are found in nearly all patients presenting with craniopharyngiomas or pineal region tumors and one‐third of patients with intracranial germ cell tumors . These include disorders of growth hormone (75%), gonadotrophin (40%), adrenocorticotropin (25%) and thyrotropin (25%).…”

Section: Discussionmentioning

confidence: 99%

Time to diagnosis of brain tumors in children: A single‐centre experience

Molineus

Boxberger

Redlich

et al. 2013

Pediatrics International

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Background: The aim of the study was to analyze the pre-diagnostic symptomatic interval (PSI) of children with brain tumors with regard to the parental and doctor's delay and the clinical symptoms. Methods: A retrospective review of all children with brain tumors diagnosed in a single centre over a period of 11 years was carried out. Results: Seventy-nine patients (35 boys, 44 girls), with a mean age of 9.2 years (0.2-23.5 years), were analyzed. PSI was 28 weeks with a parental delay of 11.1 weeks and a doctor's delay of 16.9 weeks. Main clinical symptoms were headache (66.7%), vomiting (57.7%), vision (46.2%) and gait (41.6) disorders and fatigue (41.0%) followed by other neurological signs. Conclusions: Diagnosis of pediatric brain tumors is often delayed in relation to the presenting symptoms. If parents report a combination of headache with other neurological abnormalities, a brain tumor should always be considered.

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Section: Discussionmentioning

confidence: 99%

Time to diagnosis of brain tumors in children: A single‐centre experience

Molineus

Boxberger

Redlich

et al. 2013

Pediatrics International

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“…6 In children, approximately 60% of pineal region tumors are of germ cell origin. 21 In these cases, the presence of a-fetoprotein or b-human chorionic gonadotropin in serum or CSF is sufficient to diagnose malignant germ cell tumors without the need for biopsy.…”

Section: Discussionmentioning

confidence: 99%

Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy

Morgenstern¹,

Osbun²,

Schwartz³

et al. 2011

FOC

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Object Simultaneous endoscopic third ventriculostomy (ETV) and tumor biopsy is a widely accepted therapeutic and diagnostic procedure for patients with noncommunicating hydrocephalus secondary to a pineal region tumor. Multiple approaches have been advocated, including the use of a steerable fiberoptic or rigid lens endoscope via 1 or 2 trajectories. However, the optimal approach has not been established based on the individual anatomical characteristics of the patient. Methods A retrospective review of patients undergoing simultaneous ETV and tumor biopsy was undertaken. Preoperative MR images were examined to measure the width of the anterior third ventricle and maximal diameters of the tumor, Monro foramen (right), and massa intermedia. The distances between the tumor and massa intermedia, tumor and anterior commissure, midbrain and massa intermedia, and the dorsum sella and anterior commissure were also recorded. Single and dual trajectory approaches were compared using paired t-tests for each parameter. Results Over an 8-year interval, 15 patients underwent simultaneous ETV and tumor management. These patients ranged from 6 to 71 years of age (mean 36.7 years); 5 were younger than 18 years of age. Seven were treated using a dual trajectory approach, and 8 were treated using a single trajectory approach. All cases were completed without complications or the need for an additional CSF diversionary procedure within 6 months. The diagnostic yield at biopsy was 86.7%. There were no statistically significant differences between the single and dual trajectory groups for the measured parameters. However, the dual trajectory group demonstrated a larger anterior third ventricular diameter (1.43 vs 1.21 cm, p = 0.29). The single trajectory group trended toward a smaller tumor–anterior commissure interval (2.23 vs 2.51 cm, p = 0.24) and a larger dorsum sella–anterior commissure distance (1.67 vs 1.49 cm, p = 0.28). Conclusions These data confirm the safety and diagnostic efficacy of simultaneous ETV and biopsy for tumors of the pineal region. Although no statistically significant differences were seen in the authors' recorded measurements, several trends suggest a role for a tailored approach to selecting a single or dual trajectory approach when using a rigid endoscope.

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“…3,6 The differential diagnosis of pineal region tumors is quite diverse, and includes pineal parenchymal tumors, brainstem gliomas, meningiomas, arachnoid cysts, germ cell tumors, ependymomas, and metastases. 3,10 A relatively new entity to be included in this differential list is the PTPR, which was first reported in 2003 by Jouvet et al 12 in a series of 6 cases.…”

Section: Discussionmentioning

confidence: 99%

Papillary tumor of the pineal region in a 15-month-old boy

Li¹,

Recinos

Orr

et al. 2011

PED

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The papillary tumor of the pineal region (PTPR) is a distinct entity that is particularly rare in the pediatric population. The authors document the youngest reported patient with this clinicopathological entity to date. A case of PTPR in a 15-month-old boy is described. Initially thought to be a tectal glioma, the tumor was later identified as a pineal region tumor after demonstrating growth on routine imaging. Diagnosis of PTPR was established by histopathological evaluation of biopsy samples, which revealed papillary, cystic, and solid tumor components. The patient's postoperative course was complicated by tumor growth despite several debulking procedures and chemotherapy, as well as persistent hydrocephalus requiring 2 endoscopic third ventriculostomies and eventual ventriculoperitoneal shunt placement. After a 15-month follow-up period, the patient has received proton-beam therapy and has a stable tumor size. The PTPR is a recently described tumor of the CNS that must be included in the differential diagnosis of pineal region masses. The biological behavior, prognosis, and appropriate treatment of PTPR have yet to be fully defined.

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Pineal region tumours in childhood

Cited by 36 publications

References 17 publications

Time to diagnosis of brain tumors in children: A single‐centre experience

Time to diagnosis of brain tumors in children: A single‐centre experience

Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy

Papillary tumor of the pineal region in a 15-month-old boy

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