Pineal region tumor (PRT)

• A Rare Presentation of Ruptured Pineal Region Teratoma with Postoperative Aseptic Meningitis
• Pituitary and pineal gland metastases from pulmonary neuroendocrine carcinoma: A case report and literature review
• Outcomes and Surgical Approaches for Pineal Region Tumors in Adults: A Retrospective Study of a Single-Center Over 12 Years
• Treatment of a Large Hemorrhagic Midbrain Cavernoma Within the Silvian Aqueduct in a Five-Year-Old Girl-A Case Report
• Machine learning decision support model construction for craniotomy approach of pineal region tumors based on MRI images
• Stroke-like migraine attack after radiation therapy (SMART) syndrome in a pediatric patient with a ventriculoperitoneal shunt: illustrative case
• Adult pineoblastoma: A prospective study and twelve-year experience from three tertiary care cancer institutes of India depicting the effect of various independent parameters and therapeutic strategy on progression and survival in this extremely rare malignancy
• Drosha: a new tumor suppressor in pineoblastoma

● wide variety of pathology: germ cell tumors (mostly germinomas, teratomas), astrocytomas, & pineal tumors (mostly pineoblastomas) account for most tumors

● pineal region tumors are more common in children than in adults

● in children, most tumors are germinomas or astrocytomas; in adults, meningiomas and gliomas predominate

● see germ cell tumors

● see pineal cysts

Pineal region tumor epidemiology.

Pineal region tumor classification.

Pineal region tumor clinical features.

see Pineal region tumor diagnosis.

see Pineal region tumor differential diagnosis.

Obstructive hydrocephalus from pineal region tumor

see Pineal region tumor treatment.

see Pineal region tumor case series.

a 72-year-old male patient with pineal region tumor and obstructive hydrocephalus for which an endoscopic third ventriculostomy was done with biopsy of the tumor showing primary colorectal origin in a patient known to be previously healthy.

Conclusion: Intracranial metastasis to the pineal region is considered rare especially in cases without widely spread systematic cancer or without presence of other metastatic lesions in the brain. The case we presented suggests that we should consider pineal region metastasis as part of our differential whenever we encounter patients with an isolated pineal lesion. Endoscopic third ventriculostomy can be a better treatment option to treat obstructive hydrocephalus caused by the lesion potentially avoiding peritoneal dissemination ¹⁾.

Cho et al. presented a case of a 75-year-old woman with known pineal region mass for 18 years, who presented with progressive classic signs and symptoms of obstructive hydrocephalus over the past six months. The preoperative imaging confirmed a contrast-enhancing pineal region tumor, which appeared to be obstructing the aqueduct of Sylvius, causing proximal obstructive hydrocephalus. 5mg/kg of ICG was delivered intravenously 24 hours before the surgery. The patient underwent an endoscopic third ventriculostomy and a biopsy of the pineal lesion. The tumor demonstrated clear near-infrared fluorescence which was distinct from surrounding third ventricle floor and ependyma. The signal to background ratio was 2.9. The final pathology report revealed a WHO Grade I pineocytoma.

They reported on a novel application of near-infrared fluorescence for tumor identification of pineal region tumors, using the Second Window ICG technique ²⁾.