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Microsurgical resection of pineal region tumors

Abstract

The extensive variety of possible histologic subtypes makes it imperative to establish a tissue diagnosis in patients with pineal region tumors. Management decisions regarding adjuvant therapy, prognosis, and follow-up strategies vary with the histologic diagnosis. Specialized surgical and stereotactic techniques have evolved to provide the neurosurgeon with an array of safe and effective options for obtaining a tissue diagnosis. Advanced microsurgical techniques combined with improved preoperative management and postoperative critical care methods have made aggressive surgical resection a mainstay of management. Aggressive surgical resection has resulted in excellent long-term prognoses for nearly all patients with benign tumors and a large percentage of patients with malignant tumors. However, pineal region surgery remains fraught with potential pitfalls, and these favorable results are dependent on an advanced level of surgical expertise.

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Fig. 1
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(modified with permission from Diane Abeloff; from [90])

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(from [115])

Fig. 4

(ac from [79]; d from [116])

Fig. 5

(from [116])

Fig. 6

(a from [79]; b from [117])

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(from [117])

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Correspondence to Jeffrey N. Bruce.

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VIDEO 1: Resection of Pineal Region Tumors: Supracerebellar Infratentorial Approach. (MP4 334617 kb)

VIDEO 2: Resection of Pineal Region Tumors: Occipital Transtentorial Approach. (M4 V 118704 kb)

VIDEO 1: Resection of Pineal Region Tumors: Supracerebellar Infratentorial Approach. (MP4 334617 kb)

VIDEO 2: Resection of Pineal Region Tumors: Occipital Transtentorial Approach. (M4 V 118704 kb)

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Sonabend, A.M., Bowden, S. & Bruce, J.N. Microsurgical resection of pineal region tumors. J Neurooncol 130, 351–366 (2016). https://doi.org/10.1007/s11060-016-2138-5

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Keywords

  • Pineal region tumor
  • Supracerebellar-infratentorial approach
  • Occipital-transtentorial approach
  • Transcallosal-interhemispheric approach
  • Microsurgery
  • Operative technique