Pineal region tumor surgery

Controversial. Some authors feel that most tumors (except germinomas, which are best treated with XRT) are amenable to open resection. Others feel that resection should be limited to ≈ 25% of tumors which area:

1. radioresistance (e.g. malignant nongerminoma GCTs): 35–50% of pineal region tumors (larger numbers occur in series not limited to pediatric patients)

2. benign (e.g. meningioma, teratomas…)

3. well-encapsulated

4. NB: malignant germ cell tumors should be without evidence of metastases (those with metastases do not benefit from surgery on the primary tumor)

5. pineocytoma: recommendation is for surgical excision + SRS for any residual

see Pineal region approach.