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Pineal gland tumors: experience from the SEER database

  • Laboratory Investigation - Human/Animal Tissue
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Pineal gland tumors are rare and account for less than 1% of all primary brain tumor diagnoses. They are more commonly seen in pediatric patients than in adults. We analyzed the available SEER data on pineal gland tumors that were diagnosed during the period 1973–2005. The cohort was subdivided into groups on the basis of tumor histology: germ cell tumors, pineal parenchymal tumors, gliomas, and other pineal tumors. Analyses of incidence, survival, factors influencing survival, and treatment modalities are provided. Among the 633 patients with pineal tumors, male sex was predominant, i.e., sex ratio was 3:1 for the whole group and 11.8:1 for those with germ cell tumors. The 5-year overall survival (OS) for the cohort was 65% ± 2.1%. Those with germ cell tumors experienced the best survival (OS = 78.9% ± 2.3%), followed by those with gliomas (OS = 61% ± 9.3%), and those with pineal parenchymal tumors (OS = 47.2% ± 4.2%). Non–germ cell tumors, absence of radiotherapy from treatment regimen, and diagnosis before 1993 were the only factors associated with a negative impact on survival. The extent of surgical tumor resection did not affect survival in any histologic subgroup. We conclude that, although pineal tumors are histologically diverse, they share some similarities due to their unique location. An aggressive surgical approach should be considered with caution in this region. Further studies on different pineal tumors subtypes are needed.

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  1. CBTRUS (2005). Statistical report: primary brain tumors in the United States—PbtCBTRotUS

  2. Brat DJ, Parisi JE, Kleinschmidt-DeMasters BK, Yachnis AT, Montine TJ, Boyer PJ, Powell SZ, Prayson RA, McLendon RE, Neuropathology Committee College of American Pathologists (2008) Surgical neuropathology update. A review of changes introduced by the WHO classification of tumours of the central nervous system, 4th edn. Arch Pathol Lab Med 132:993–1007

    PubMed  Google Scholar 

  3. Kersh CR, Constable CW, Eisert DR, Spaulding CA, Hahn SS, Jenrette JM III, Marks RD Jr (1988) Primary central nervous system germ cell tumors. Effect of histologic confirmation on radiotherapy. Cancer 61:2148–2152

    Article  PubMed  CAS  Google Scholar 

  4. Maria E, Echeverria JF, Goldman S (2008) Pediatric central nervous system germ cell tumors: a review. Oncologist 13:690–699. doi:10.1634/theoncologist.2008-0037

    Article  Google Scholar 

  5. Roger J, Packer TM, Vezina Gilbert (2008) Central nervous system tumors. Pediatr Clin North Am 55:121–145. doi:10.1016/j.pcl.2007.10.010

    Article  Google Scholar 

  6. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (2007) Germ cell tumours. WHO classification of tumours of the central nervous system. IARC, Lyon, pp 197–204

  7. Hirato J, Nakazato Y (2001) Pathology of pineal region tumors. J Neurooncol 54:239–249. doi:10.1023/A:1012721723387

    Article  PubMed  CAS  Google Scholar 

  8. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (2007) Tumours of the pineal region. WHO classification of tumours of the central nervous system. IARC Lyon, pp 121–126

  9. Kumar P, Tatke M, Sharma A, Singh D (2006) Histological analysis of lesions of the pineal region: a retrospective study of 12 years. Pathol Res Pract 202:85–92. doi:10.1016/j.prp.2005.11.006

    Article  PubMed  Google Scholar 

  10. Surveillance, Epidemiology, and End Results (SEER) Program ( SEER*Stat Database: Incidence - SEER 17 Regs Limited-Use + Hurricane Katrina Impacted Louisiana Cases, Nov 2007 Sub (1973–2005 varying) - Linked To County Attributes - Total US, 1969–2005 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2008, based on the November 2007 submission

  11. Herrick MK, Rubinstein LJ (1979) The cytological differentiating potential of pineal parenchymal neoplasms (true pinealomas). A clinicopathological study of 28 tumours. Brain 102:289–320. doi:10.1093/brain/102.2.289

    Article  PubMed  CAS  Google Scholar 

  12. Packer RJ, Sutton LN, Rosenstock JG, Rorke LB, Bilaniuk LT, Zimmerman RA, Littman PA, Bruce DA, Schut L (1984) Pineal region tumors of childhood. Pediatr 74:97–102

    CAS  Google Scholar 

  13. Hoffman HJ, Yoshida M, Becker LE, Hendrick EB, Humphreys RP (1983) Pineal region tumors in childhood. Experience at the hospital for sick children. Pediatr Neurosurg 4:360–386

    Google Scholar 

  14. Rubenstein LJ (1972) Tumors of the central nervous system. Armed Force Institute of Pathology, Washington, DC

    Google Scholar 

  15. Reddy AT, Janss AJ, Phillips PC, Weiss HL, Packer RJ (2000) Outcome for children with supratentorial primitive neuroectodermal tumors treated with surgery, radiation, and chemotherapy. Cancer 88:2189–2193. doi:10.1002/(SICI)1097-0142(20000501)88:9<2189::AID-CNCR27>3.0.CO;2-G

    Article  PubMed  CAS  Google Scholar 

  16. Kleihues P, Burger PC, Scheithauer BW (1993) The new WHO classification of brain tumours. Brain Pathol 3:255–268. doi:10.1111/j.1750-3639.1993.tb00752.x

    Article  PubMed  CAS  Google Scholar 

  17. Christian H, Rickert WP (2005) Prognosis-related histomorphological and immunohistochemical markers in central nervous system tumors of childhood and adolescence. Acta Neuropathol 109:69–92. doi:10.1007/s00401-004-0959-3

    Article  CAS  Google Scholar 

  18. Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446–455

    Article  PubMed  CAS  Google Scholar 

  19. Schild SE, Scheithauer BW, Schomberg PJ, Hook CC, Kelly PJ, Frick L, Robinow JS, Buskirk SJ (1993) Pineal parenchymal tumors. Clinical, pathologic, and therapeutic aspects. Cancer 72:870–880. doi:10.1002/1097-0142(19930801)72:3<870::AID-CNCR2820720336>3.0.CO;2-X

    Article  PubMed  CAS  Google Scholar 

  20. Fauchon F, Jouvet A, Paquis P, Saint-Pierre G, Mottolese C, Ben Hassel M, Chauveinc L, Sichez JP, Philippon J, Schlienger M, Bouffet E (2000) Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys 46:959–968. doi:10.1016/S0360-3016(99)00389-2

    PubMed  CAS  Google Scholar 

  21. Jouvet A, Saint-Pierre G, Fauchon F, Privat K, Bouffet E, Ruchoux MM, Chauveinc L, Fèvre-Montange M (2000) Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. Brain Pathol 10:49–60

    PubMed  CAS  Google Scholar 

  22. Gilles FH, Tavare CJ, Becker LE, Burger PC, Yates AJ, Pollack IF, Finlay JL (2008) Pathologist interobserver variability of histologic features in childhood brain tumors: results from the CCG-945 study. Pediatr Dev Pathol 11:108–117. doi:10.2350/07-06-0303.1

    Article  PubMed  Google Scholar 

  23. Villano JL, Propp JM, Porter KR, Stewart AK, Valyi-Nagy T, Li X, Engelhard HH, McCarthy BJ (2008) Malignant pineal germ-cell tumors: an analysis of cases from three tumor registries. Neuro-oncol 10:121–130. doi:10.1215/15228517-2007-054

    Article  PubMed  Google Scholar 

  24. Nomura K (2001) Epidemiology of germ cell tumors in Asia of pineal region tumor. J Neurooncol 54:211–217. doi:10.1023/A:1012771204732

    Article  PubMed  CAS  Google Scholar 

  25. Konovalov ANPD, Pitskhelauri DI (2003) Principles of treatment of the pineal region tumors. Surg Neurol 59:250–268. doi:10.1016/S0090-3019(03)00223-4

    Article  PubMed  Google Scholar 

  26. Regis J, Bouillot P, Rouby-Volot F, Figarella-Branger D, Dufour H, Peragut JC (1996) Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases. Neurosurgery 39:907–912. doi:10.1097/00006123-199611000-00003

    Article  PubMed  CAS  Google Scholar 

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The authors would like to thank Dr Amar J. Gajjar for his help and Angela McArthur for the scientific editing of this manuscript. This work was supported in part by grant CA21765 from the U.S. Publish Health Service, the American Lebanese Syrian Associated Charities (ALSAC), and the King Hussein Cancer Foundation (KHCF).

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Correspondence to Maysa Al-Hussaini.

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Al-Hussaini, M., Sultan, I., Abuirmileh, N. et al. Pineal gland tumors: experience from the SEER database. J Neurooncol 94, 351–358 (2009).

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