Skip to main content
SpringerLink
Log in

Pineal Region Tumors

  • Chapter
  • First Online:
Primary Central Nervous System Tumors

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

The pineal gland was first discovered in 300 B.C. by Herophilus [1]. The first pineal tumor was reported in a 20-year-old woman in 1717 by Charles Drélincourt [1] and the first reported attempt at a pineal tumor resection was in 1910 by Hosley [2]. Since then, there has been ongoing debate about optimal management of pineal tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Borit A. History of tumors of the pineal region. Am J Surg Pathol. 1981;5:613–20.

    Article  CAS  PubMed  Google Scholar 

  2. Yamamoto I, Kageyama N. Microsurgical anatomy of the pineal region. J Neurosurg. 1980;53:205–21.

    Article  CAS  PubMed  Google Scholar 

  3. Erlich SS, Apuzzo ML. The pineal gland: anatomy, physiology, and clinical significance. J Neurosurg. 1985;63:321–41.

    Article  CAS  PubMed  Google Scholar 

  4. Pandi-Perumal SR, Trakht I, Srinivasan V et al. Physiological effects of melatonin: role of melatonin receptors and signal transduction pathways. Prog Neurobiol. 2008;85:335–53.

    Article  CAS  PubMed  Google Scholar 

  5. Macchi MM, Bruce JN. Human pineal physiology and functional significance of melatonin. Front Neuroendocrinol. 2004;25:177–95.

    Article  CAS  PubMed  Google Scholar 

  6. Pandi-Perumal SR, Srinivasan V, Maestroni GJ et al. Melatonin: nature’s most versatile biological signal?. FEBS J. 2006;273:2813–38.

    Article  CAS  PubMed  Google Scholar 

  7. Blakeley JO, Grossman SA. Management of pineal region tumors. Curr Treat Options Oncol. 2006;7:505–16.

    Article  PubMed  Google Scholar 

  8. Shibui S, Nomura K. Statistical analysis of pineal tumors based on the data of Brain Tumor Registry of Japan. Prog Neurol Surg. 2009;23:1–11.

    Article  PubMed  Google Scholar 

  9. Konovalov AN, Pitskhelauri DI. Principles of treatment of the pineal region tumors. Surg Neurol. 2003;59:250–68.

    Article  PubMed  Google Scholar 

  10. Drummond KJ, Rosenfeld JV. Pineal region tumours in childhood. A 30-year experience. Childs Nerv Syst. 1999;15:119–26. discussion 27.

    Article  CAS  PubMed  Google Scholar 

  11. Matsutani M. Pineal germ cell tumors. Prog Neurol Surg. 2009;23:76–85.

    Article  PubMed  Google Scholar 

  12. Dodek AB, Sadeghi-Nejad A. Pineal germinoma presenting as central diabetes insipidus. Clin Pediatr (Phila). 1998;37:693–95.

    Article  CAS  Google Scholar 

  13. Jan JE, Tai J, Hahn G, Rothstein RR. Melatonin replacement therapy in a child with a pineal tumor. J Child Neurol. 2001;16:139–40.

    CAS  PubMed  Google Scholar 

  14. Grimoldi N, Tomei G, Stankov B et al. Neuroendocrine, immunohistochemical, and ultrastructural study of pineal region tumors. J Pineal Res. 1998;25:147–58.

    Article  CAS  PubMed  Google Scholar 

  15. Diez B, Balmaceda C, Matsutani M, Weiner HL. Germ cell tumors of the CNS in children: recent advances in therapy. Childs Nerv Syst. 1999;15:578–85.

    Article  CAS  PubMed  Google Scholar 

  16. Matsutani M. Clinical management of primary central nervous system germ cell tumors. Semin Oncol. 2004;31:676–83.

    Article  PubMed  Google Scholar 

  17. Nomura K. Epidemiology of germ cell tumors in Asia of pineal region tumor. J Neurooncol. 2001;54:211–7.

    Article  CAS  PubMed  Google Scholar 

  18. Korogi Y, Takahashi M, Ushio Y. MRI of pineal region tumors. J Neurooncol. 2001;54:251–61.

    Article  CAS  PubMed  Google Scholar 

  19. Hirato J, Nakazato Y. Pathology of pineal region tumors. J Neurooncol. 2001;54:239–49.

    Article  CAS  PubMed  Google Scholar 

  20. Hattab EM, Tu PH, Wilson JD, Cheng L. OCT4 immunohistochemistry is superior to placental alkaline phosphatase (PLAP) in the diagnosis of central nervous system germinoma. Am J Surg Pathol. 2005;29:368–71.

    Article  PubMed  Google Scholar 

  21. Nakamura H, Takeshima H, Makino K, Kuratsu J. C-kit expression in germinoma: an immunohistochemistry-based study. J Neurooncol. 2005;75:163–7.

    Article  CAS  PubMed  Google Scholar 

  22. Sato K, Takeuchi H, Kubota T. Pathology of intracranial germ cell tumors. Prog Neurol Surg. 2009;23:59–75.

    Article  PubMed  Google Scholar 

  23. Matsutani M, Sano K, Takakura K et al. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg. 1997;86:446–55.

    Article  CAS  PubMed  Google Scholar 

  24. Nakagawa Y, Perentes E, Ross GW, Ross AN, Rubinstein LJ. Immunohistochemical differences between intracranial germinomas and their gonadal equivalents. An immunoperoxidase study of germ cell tumors with epithelial membrane antigen, cytokeratin, and vimentin. J Pathol. 1988;156:67–72.

    Article  CAS  PubMed  Google Scholar 

  25. Ho DM, Liu HC. Primary intracranial germ cell tumor. Pathologic study of 51 patients. Cancer 1992;70:1577–84.

    Article  CAS  PubMed  Google Scholar 

  26. Kobayashi T, Kida Y, Mori Y. Stereotactic gamma radiosurgery for pineal and related tumors. J Neurooncol. 2001;54:301–9.

    Article  CAS  PubMed  Google Scholar 

  27. Kaido T, Sasaoka Y, Hashimoto H, Taira K. De novo germinoma in the brain in association with Klinefelter’s syndrome: case report and review of the literature. Surg Neurol. 2003;60:553–8. discussion 9.

    Article  PubMed  Google Scholar 

  28. Volkl TM, Langer T, Aigner T et al. Klinefelter syndrome and mediastinal germ cell tumors. Am J Med Genet A. 2006;140:471–81.

    PubMed  Google Scholar 

  29. Tanabe M, Mizushima M, Anno Y et al. Intracranial germinoma with Down’s syndrome: a case report and review of the literature. Surg Neurol. 1997;47:28–31.

    Article  CAS  PubMed  Google Scholar 

  30. Wong TT, Ho DM, Chang TK, Yang DD, Lee LS. Familial neurofibromatosis 1 with germinoma involving the basal ganglion and thalamus. Childs Nerv Syst. 1995;11:456–8.

    Article  CAS  PubMed  Google Scholar 

  31. Tan HW, Ty A, Goh SG et al. Pineal yolk sac tumour with a solid pattern: a case report in a Chinese adult man with Down’s syndrome. J Clin Pathol. 2004;57:882–4.

    Article  CAS  PubMed  Google Scholar 

  32. Rickert CH, Simon R, Bergmann M, Dockhorn-Dworniczak B, Paulus W. Comparative genomic hybridization in pineal germ cell tumors. J Neuropathol Exp Neurol. 2000;59:815–21.

    CAS  PubMed  Google Scholar 

  33. Palmer RD, Foster NA, Vowler SL et al. Malignant germ cell tumours of childhood: new associations of genomic imbalance. Br J Cancer. 2007;96:667–76.

    Article  CAS  PubMed  Google Scholar 

  34. Ogawa K, Toita T, Nakamura K et al. Treatment and prognosis of patients with intracranial nongerminomatous malignant germ cell tumors. Cancer 2003;98:369–76.

    Article  PubMed  Google Scholar 

  35. Kyritsis AP. Management of primary intracranial germ cell tumors. J Neurooncol. 2010;96:143–9.

    Article  PubMed  Google Scholar 

  36. Sawamura Y, Ikeda J, Shirato H, Tada M, Abe H. Germ cell tumours of the central nervous system: treatment consideration based on 111 cases and their long-term clinical outcomes. Eur J Cancer. 1998;34:104–10.

    Article  CAS  PubMed  Google Scholar 

  37. Sato K, Kubota T. Pathology of pineal parenchymal tumors. Prog Neurol Surg. 2009;23:12–25.

    Article  PubMed  Google Scholar 

  38. Plowman PN, Pizer B, Kingston JE. Pineal parenchymal tumours: II. On the aggressive behaviour of pineoblastoma in patients with an inherited mutation of the RB1 gene. Clin Oncol (R Coll Radiol). 2004;16:244–7.

    CAS  Google Scholar 

  39. Rickert CH, Simon R, Bergmann M, Dockhorn-Dworniczak B, Paulus W. Comparative genomic hybridization in pineal parenchymal tumors. Genes Chromosomes Cancer. 2001;30:99–104.

    Article  CAS  PubMed  Google Scholar 

  40. Fevre-Montange M, Champier J, Szathmari A et al. Microarray analysis reveals differential gene expression patterns in tumors of the pineal region. J Neuropathol Exp Neurol. 2006;65:675–84.

    Article  CAS  PubMed  Google Scholar 

  41. Lutterbach J, Fauchon F, Schild SE et al. Malignant pineal parenchymal tumors in adult patients: patterns of care and prognostic factors. Neurosurgery 2002;51:44–55. discussion – 6.

    Article  PubMed  Google Scholar 

  42. Guillamo JS, Monjour A, Taillandier L et al. Brainstem gliomas in adults: prognostic factors and classification. Brain 2001;124:2528–39.

    Article  CAS  PubMed  Google Scholar 

  43. Ternier J, Wray A, Puget S et al. Tectal plate lesions in children. J Neurosurg. 2006;104:369–76.

    Article  PubMed  Google Scholar 

  44. Bowers DC, Georgiades C, Aronson LJ et al. Tectal gliomas: natural history of an indolent lesion in pediatric patients. Pediatr Neurosurg. 2000;32:24–9.

    Article  CAS  PubMed  Google Scholar 

  45. Stark AM, Fritsch MJ, Claviez A, Dorner L, Mehdorn HM. Management of tectal glioma in childhood. Pediatr Neurol. 2005;33:33–8.

    Article  PubMed  Google Scholar 

  46. Moon KS, Jung S, Jung TY et al. Primary glioblastoma in the pineal region: a case report and review of the literature. J Med Case Reports. 2008;2:288.

    Article  PubMed  Google Scholar 

  47. Amini A, Schmidt RH, Salzman KL, Chin SS, Couldwell WT. Glioblastoma multiforme of the pineal region. J Neurooncol. 2006;79:307–14.

    Article  PubMed  Google Scholar 

  48. Fukushima S, Terasaki M, Shigemori M. Chordoid meningioma arising in the pineal region: a case report. Brain Tumor Pathol. 2008;25:91–5.

    Article  PubMed  Google Scholar 

  49. Konovalov AN, Spallone A, Pitzkhelauri DI. Meningioma of the pineal region: a surgical series of 10 cases. J Neurosurg. 1996;85:586–90.

    Article  CAS  PubMed  Google Scholar 

  50. Matushita H, Pinto FC, Plese JP. Meningiomas of pineal region in children. Arq Neuropsiquiatr. 2007;65:1000–6.

    PubMed  Google Scholar 

  51. Jouvet A, Fauchon F, Liberski P et al. Papillary tumor of the pineal region. Am J Surg Pathol. 2003;27:505–12.

    Article  PubMed  Google Scholar 

  52. Sharma MC, Jain D, Sarkar C et al. Papillary tumor of the pineal region–a recently described entity: a report of three cases and review of the literature. Clin Neuropathol. 2009;28:295–302.

    CAS  PubMed  Google Scholar 

  53. Fevre-Montange M, Hasselblatt M, Figarella-Branger D et al. Prognosis and histopathologic features in papillary tumors of the pineal region: a retrospective multicenter study of 31 cases. J Neuropathol Exp Neurol. 2006;65:1004–11.

    Article  PubMed  Google Scholar 

  54. Coello AF, Torres A, Acebes JJ, Boluda S. Papillary tumor of the pineal region. Neurology 2009;73:486.

    Article  PubMed  Google Scholar 

  55. Committee of Brain Tumor Registry of Japan (1969–1996). Neurol Med Chir (Tokyo). 2003;43 Suppl:i–vii:1–111.

    Google Scholar 

  56. Kakita A, Kobayashi K, Aoki N et al. Lung carcinoma metastasis presenting as a pineal region tumor. Neuropathology 2003;23:57–60.

    Article  PubMed  Google Scholar 

  57. Naugler C, Xu Z. Pancreatic adenocarcinoma metastatic to the pineal gland. J Clin Neurosci. 2008;15:1284–6.

    Article  PubMed  Google Scholar 

  58. Lassman AB, Bruce JN, Fetell MR. Metastases to the pineal gland. Neurology 2006;67:1303–4.

    Article  PubMed  Google Scholar 

  59. Yamini B, Refai D, Rubin CM, Frim DM. Initial endoscopic management of pineal region tumors and associated hydrocephalus: clinical series and literature review. J Neurosurg. 2004;100:437–41.

    PubMed  Google Scholar 

  60. Knierim DS, Yamada S. Pineal tumors and associated lesions: the effect of ethnicity on tumor type and treatment. Pediatr Neurosurg. 2003;38:307–23.

    Article  PubMed  Google Scholar 

  61. Maity A, Shu HK, Janss A et al. Craniospinal radiation in the treatment of biopsy-proven intracranial germinomas: twenty-five years’ experience in a single center. Int J Radiat Oncol Biol Phys. 2004;58:1165–70.

    Article  PubMed  Google Scholar 

  62. Calaminus G, Bamberg M, Jurgens H et al. Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89. Klin Padiatr. 2004;216:141–9.

    Article  CAS  PubMed  Google Scholar 

  63. Kellie SJ, Boyce H, Dunkel IJ et al. Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach. Pediatr Blood Cancer. 2004;43:126–33.

    Article  PubMed  Google Scholar 

  64. Kretschmar C, Kleinberg L, Greenberg M et al. Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children’s Oncology Group. Pediatr Blood Cancer. 2007;48:285–91.

    Article  CAS  PubMed  Google Scholar 

  65. Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg. 1985;63:155–67.

    Article  CAS  PubMed  Google Scholar 

  66. Kochi M, Itoyama Y, Shiraishi S et al. Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg. 2003;99:106–14.

    Article  PubMed  Google Scholar 

  67. Kellie SJ, Boyce H, Dunkel IJ et al. Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol. J Clin Oncol. 2004;22:846–53.

    Article  CAS  PubMed  Google Scholar 

  68. Sawamura Y, Kato T, Ikeda J et al. Teratomas of the central nervous system: treatment considerations based on 34 cases. J Neurosurg. 1998;89:728–37.

    Article  CAS  PubMed  Google Scholar 

  69. Deshmukh VR, Smith KA, Rekate HL, Coons S, Spetzler RF. Diagnosis and management of pineocytomas. Neurosurgery 2004;55:349–55. discussion 55–7.

    Article  PubMed  Google Scholar 

  70. Fauchon F, Jouvet A, Paquis P et al. Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys. 2000;46:959–68.

    Article  CAS  PubMed  Google Scholar 

  71. Reyns N, Hayashi M, Chinot O et al. The role of Gamma Knife radiosurgery in the treatment of pineal parenchymal tumours. Acta Neurochir (Wien). 2006;148:5-11. discussion.

    Article  CAS  Google Scholar 

  72. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford D. Role of stereotactic radiosurgery in the management of pineal parenchymal tumors. Prog Neurol Surg. 2009;23:44–58.

    Article  PubMed  Google Scholar 

  73. Gilheeney SW, Saad A, Chi S et al. Outcome of pediatric pineoblastoma after surgery, radiation and chemotherapy. J Neurooncol. 2008;89:89–95.

    Article  PubMed  Google Scholar 

  74. Lee JY, Wakabayashi T, Yoshida J. Management and survival of pineoblastoma: an analysis of 34 adults from the brain tumor registry of Japan. Neurol Med Chir (Tokyo). 2005;45:132–41. discussion 41–2.

    Article  Google Scholar 

  75. Duffner PK, Horowitz ME, Krischer JP et al. The treatment of malignant brain tumors in infants and very young children: an update of the Pediatric Oncology Group experience. Neuro-oncol 1999;1:152–61.

    CAS  PubMed  Google Scholar 

  76. Graham ML, Herndon JE 2nd, Casey JR et al. High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors. J Clin Oncol. 1997;15:1814–23.

    CAS  PubMed  Google Scholar 

  77. Gururangan S, McLaughlin C, Quinn J et al. High-dose chemotherapy with autologous stem-cell rescue in children and adults with newly diagnosed pineoblastomas. J Clin Oncol. 2003;21:2187–91.

    Article  CAS  PubMed  Google Scholar 

  78. Hinkes BG, von Hoff K, Deinlein F et al. Childhood pineoblastoma: experiences from the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91. J Neurooncol. 2007;81:217–23.

    Article  CAS  PubMed  Google Scholar 

  79. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD. The role of radiosurgery for the treatment of pineal parenchymal tumors. Neurosurgery 2002;51:880–9.

    Article  PubMed  Google Scholar 

  80. Julow J, Viola A, Major T. Review of radiosurgery of pineal parenchymal tumors. Long survival following 125-iodine brachytherapy of pineoblastomas in 2 cases. Minim Inv Neurosurg. 2006;49:276–81.

    Article  CAS  Google Scholar 

  81. Pusztaszeri M, Pica A, Janzer R. Pineal parenchymal tumors of intermediate differentiation in adults: case report and literature review. Neuropathology 2006;26:153–7.

    Article  PubMed  Google Scholar 

  82. Senft C, Raabe A, Hattingen E et al. Pineal parenchymal tumor of intermediate differentiation: diagnostic pitfalls and discussion of treatment options of a rare tumor entity. Neurosurg Rev. 2008;31:231–6.

    Article  PubMed  Google Scholar 

  83. Anan M, Ishii K, Nakamura T et al. Postoperative adjuvant treatment for pineal parenchymal tumour of intermediate differentiation. J Clin Neurosci. 2006;13:965–8.

    Article  CAS  PubMed  Google Scholar 

  84. Yeh DD, Warnick RE, Ernst RJ. Management strategy for adult patients with dorsal midbrain gliomas. Neurosurgery 2002;50:735–38. discussion 8–40.

    Article  PubMed  Google Scholar 

  85. Daglioglu E, Cataltepe O, Akalan N. Tectal gliomas in children: the implications for natural history and management strategy. Pediatr Neurosurg. 2003;38:223–31.

    Article  PubMed  Google Scholar 

  86. Grant GA, Avellino AM, Loeser JD et al. Management of intrinsic gliomas of the tectal plate in children. A ten-year review. Pediatr Neurosurg. 1999;31:170–6.

    Article  CAS  PubMed  Google Scholar 

  87. Ruda R, Gilbert M, Soffietti R. Ependymomas of the adult: molecular biology and treatment. Curr Opin Neurol. 2008;21:754–61.

    Article  PubMed  Google Scholar 

  88. Little AS, Sheean T, Manoharan R, Darbar A, Teo C. The management of completely resected childhood intracranial ependymoma: the argument for observation only. Childs Nerv Syst. 2009;25:281–4.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Dr. Peter Burger and Ms. Patricia Goldwaite for their assistance in preparing this chapter.

Author information

Authors and Affiliations

  1. Queens University School of Medicine, Kingston, ON, Canada

    Harry C. Brastianos PhD

  2. Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Priscilla K. Brastianos MD

  3. Departments of Neurology, Oncology, and Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, 21231, USA

    Jaishri Blakeley

Authors
  1. Harry C. Brastianos PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Priscilla K. Brastianos MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaishri Blakeley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jaishri Blakeley .

Editor information

Editors and Affiliations

  1. Dana-Farber Cancer Institute, Harvard Medical School, Binney St. 44, Boston, 02115, Massachusetts, USA

    Andrew D. Norden

  2. Departments of Surgery and Pediatrics, Duke University Medical Center, Durham, 27710, North Carolina, USA

    David A. Reardon

  3. Dana-Farber Cancer Institute, Harvard Medical School, Binney St. 44, Boston, 02115, Massachusetts, USA

    Patrick C. Y. Wen

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Brastianos, H.C., Brastianos, P.K., Blakeley, J. (2011). Pineal Region Tumors. In: Norden, A., Reardon, D., Wen, P. (eds) Primary Central Nervous System Tumors. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-60761-166-0_19

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-166-0_19

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-165-3

  • Online ISBN: 978-1-60761-166-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation