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Management of mature pineal region teratomas in pediatric age group

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Abstract

Purpose

Mature pineal region teratomas differ from other pineal tumors in terms of their characteristic radiological appearance and their clinical outcome after gross total excision. Our aim is to share our clinical experience and treatment outcomes in pediatric patients with mature pineal region teratoma.

Methods

In this retrospective study, we reviewed clinical, radiological, and surgical data of ten patients who had radiologically predicted diagnosis of pineal region teratoma and pathologically confirmed diagnosis of mature pineal region teratoma between years 2004 and 2017 in our clinic. Statistical analysis was performed with SPSS 20.

Results

All patients were male. Ages of patients ranged between 5 and 17 (median age was 9.5). All of them presented with headache. Magnetic resonance imaging showed characteristic appearance of teratomas with variable degree of hydrocephalus. All patients had negative results for AFP and b-HCG levels. All patients had gross total resection of pineal tumor through occipital transtentorial approach with no permanent neurological deficit. Pathological results of all tumor samples were consistent with mature teratoma. None of them had adjuvant chemotherapy or radiotherapy. Follow-up periods ranged between 3 and 170 months (median follow-up period was 60.5 months). All patients are alive with no tumor recurrence.

Conclusions

Pediatric mature pineal region teratomas are benign tumors with characteristic MRI appearance and negative tumor markers. Their definitive treatment is gross total surgical excision. Occipital transtentorial approach is a safe procedure for treatment of pediatric mature pineal teratomas.

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Acknowledgments

We would like to thank Dr. Ayca Ersen for her cooperation in pathological diagnosis of the specimens and preparation of figures of pathological specimens for this study.

Author information

Correspondence to Bahattin Tanrıkulu.

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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Informed consent was obtained from all individual participants included in the study.

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Tanrıkulu, B., Özek, M.M. Management of mature pineal region teratomas in pediatric age group. Childs Nerv Syst 36, 153–163 (2020) doi:10.1007/s00381-019-04204-1

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Keywords

  • Pineal
  • Radiology
  • Mature teratoma
  • Treatment
  • Pediatric age