Tumors of the Pineal Region

Ringertz, Nils R.; Nordenstam, H; Flyger, G.

doi:10.1097/00005072-195410000-00004

Cited by 91 publications

(12 citation statements)

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“…In addition to differences in situation we have various histological types of intra-and extra-ventrieular tumours. Ringertz et al (1954), Ziilch (1956, Russell and Rubinstein (1959), Araki and Matsumoto (1969), Davis (in Smith and Estridge 1974), and others have pointed out that pinealomas and teratomas of the brain are most frequently in the pineal region. Gliomas of various types also appear in this region, and, less frequently, epidermoids and meningiomas originate in the velum interpositum or the posterior margin of the falx.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of tumours of the pineal region

1976

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Tumours of the pineal region and posterior part of the third ventricle are rare in European and American series (0.5 to 1% of space-occupying lesions). Personal experience is usually limited and thus cooperative studies or critical reviews of reported cases are necessary to establish therapeutic criteria. We have studied 50 cases from our own material of more than 5,000 brain tumours and intracranial space-occupying lesions operated on during the last 30 years. Another 6 verified cases from Dr. F. Isamat, and more than 200 verified tumours from the literature are added. Histological distribution shows that 24% of the tumours in this locality are benign. The different surgical techniques fro reaching the pineal region are reviewed. The results of palliative operations, or partial removals together with radiotherapy, and total removals are presented in 200 verified cases (Table 1), as well as the results obtained by the different surgical approaches (Table 2). Finally, some conclusions are reached regarding the surgical management of these tumours. More than two thirds are radiosensitive, and in about 50 to 70% good results may be obtained with palliative operations and radiotherapy. The remainder of the pineal tumours (about 20%) should be treated by a direct surgical approach. Recent technical improvements and the use of the surgical microscope have reduced the mortality of pineal surgery and allow verification of the histological nature of the tumour in order to establish more rational treatment.

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Section: Discussionmentioning

confidence: 99%

Surgical management of tumours of the pineal region

1976

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“…Gliomas in the pineal region include fibrillary astrocytoma, pilocytic astrocytoma, anaplastic astrocytoma, glioblastoma, oligodendroglioma, ependymoma, and choroid plexus papilloma (2). Glioblastoma multiforme (GBM) is rarely found in the pineal region.…”

Section: Introductionmentioning

confidence: 99%

Pineal Region Glioblastoma, a Case Report and Literature Review

Stowe

Miller

et al. 2017

Front. Oncol.

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IntroductionPineal 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 backgroundA 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.DiscussionOn 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 remarksAlthough 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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“…1,3,15,21,24,27,29,31,34,41,47,51,52 In the pre-microneurosurgical era, mortality rates after surgery for pineal region and posterior third ventricle tumours was high, between 50% and 70%, probably because of the critical location adjacent to the midbrain and the deep cerebral veins. 54,[67][68][69][70][71] Microsurgical techniques have significantly reduced mortality rates to about 2%. 4,54,68 Gross total resection should be aggressively sought whenever possible as this holds the potential for cure or for long disease-free periods in many patients.…”

Section: Discussionmentioning

confidence: 99%