Pineal Region Tumors
Abstract
Pineal region tumors are rare intracranial neoplasms that include germinomas, nongerminomatous germ cell tumors, and pineal parenchymal tumors. Because of their heterogeneous nature, a tissue diagnosis via an open surgical, endoscopic, or stereotactic approach is essential to determine the best treatment strategy. Therapeutic options in the past have included varying combinations of surgical excision, wide field fractionated radiation therapy, and chemotherapy. Although the experience with stereotactic radiosurgery is still limited to relatively small series and case reports, there is increasing evidence that this modality may have an important adjuvant role in treating malignant pineal tumors and benign tumors that are not amendable to complete surgical resection. Stereotactic radiosurgery has also been used successfully to treat pineal region tumors that have recurred despite standard therapy.
Keywords
Pineal Gland Stereotactic Biopsy Pineal Region Mature Teratoma Choroid Plexus PapillomaReferences
- 1.Baumgartner JE, Edwards MS. Pineal tumors. Neurosurg Clin N Am. 1992;3:853–62.PubMedGoogle Scholar
- 2.Bruce JN. Pineal tumors Historical perspective. In: Winn HR, editor. Youman’s neurologica surgery. Philadelphia: Elsevier; 2005. p. 1–6.Google Scholar
- 3.Yamamoto I, Kageyama N. Microsurgical anatomy of the pineal region. J Neurosurg. 1980;53:205–21.CrossRefPubMedGoogle Scholar
- 4.Stein BM. Supracerebellar-infratentorial approach to pineal tumors. Surg Neurol. 1979;11:331–7.PubMedGoogle Scholar
- 5.Knierim DS, Yamada S. Pineal tumors and associated lesions: the effect of ethnicity on tumor type and treatment. Pediatr Neurosurg. 2003;38:307–23.CrossRefPubMedGoogle Scholar
- 6.Oi S, Matsumoto S. Controversy pertaining to therapeutic modalities for tumors of the pineal region: a worldwide survey of different patient populations. Childs Nerv Syst. 1992;8:332–6.CrossRefPubMedGoogle Scholar
- 7.Regis J, Bouillot P, Rouby-Volot F, et al. Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases. Neurosurgery. 1996;39:907–12.PubMedGoogle Scholar
- 8.Fukushima T. Endoscopic biopsy of intraventricular tumors with the use of a ventriculofiberscope. Neurosurgery. 1978;2:110–3.CrossRefPubMedGoogle Scholar
- 9.Fukushima T, Ishijima B, Hirakawa K, et al. Ventriculofiberscope: a new technique for endoscopic diagnosis and operation. Technical note J Neurosurg. 1973;38:251–6.CrossRefPubMedGoogle Scholar
- 10.Robinson S, Cohen AR. The role of neuroendoscopy in the treatment of pineal region tumors. Surg Neurol. 1997;48:360–5.CrossRefPubMedGoogle Scholar
- 11.Oi S, Shibata M, Tominaga J, et al. Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study. J Neurosurg. 2000;93:245–53.CrossRefPubMedGoogle Scholar
- 12.Bruce JN, Stein BM. Surgical management of pineal region tumors. Acta Neurochir (Wien). 1995;134:130–5.CrossRefGoogle Scholar
- 13.Bruce JN, Ogden AT. Surgical strategies for treating patients with pineal region tumors. J Neurooncol. 2004;69:221–36.CrossRefPubMedGoogle Scholar
- 14.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.CrossRefPubMedGoogle Scholar
- 15.Weiner HL, Finlay JL. Surgery in the management of primary intracranial germ cell tumors. Childs Nerv Syst. 1999;15:770–3.CrossRefPubMedGoogle Scholar
- 16.Sung DI, Harisiadis L, Chang CH. Midline pineal tumors and suprasellar germinomas: highly curable by irradiation. Radiology. 1978;128:745–51.CrossRefPubMedGoogle Scholar
- 17.Dattoli MJ, Newall J. Radiation therapy for intracranial germinoma: the case for limited volume treatment. Int J Radiat Oncol Biol Phys. 1990;19:429–33.CrossRefPubMedGoogle Scholar
- 18.Balmaceda C, Heller G, Rosenblum M, et al. Chemotherapy without irradiation—a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. The First International Central Nervous System Germ Cell Tumor Study. J Clin Oncol. 1996;14:2908–15.PubMedGoogle Scholar
- 19.Buckner JC, Peethambaram PP, Smithson WA, et al. Phase II trial of primary chemotherapy followed by reduced-dose radiation for CNS germ cell tumors. J Clin Oncol. 1999;17:933–40.PubMedGoogle Scholar
- 20.Backlund EO, Rahn T, Sarby B. Treatment of pinealomas by stereotaxic radiation surgery. Acta Radiol Ther Phys Biol. 1974;13:368–76.CrossRefPubMedGoogle Scholar
- 21.Subach BR, Lunsford LD, Kondziolka D. Stereotactic radiosurgery in the treatment of pineal region tumors. Prog Neurol Surg. 1998;14:175–94.CrossRefGoogle Scholar
- 22.Hasegawa T, Kondziolka D, Hadjipanayis CG, et al. The role of radiosurgery for the treatment of pineal parenchymal tumors. Neurosurgery. 2002;51:880–9.PubMedGoogle Scholar
- 23.Manera L, Regis J, Chinot O, et al. Pineal region tumors: the role of stereotactic radiosurgery. Stereotact Funct Neurosurg. 1996;66 Suppl 1:164–73.CrossRefPubMedGoogle Scholar
- 24.Kano H, Niranjan A, Kondziolka D, et al. Role of stereotactic radiosurgery in the management of pineal parenchymal tumors. Prog Neurol Surg. 2009;23:44–58.CrossRefPubMedGoogle Scholar
- 25.Casentini L, Colombo F, Pozza F, et al. Combined radiosurgery and external radiotherapy of intracranial germinomas. Surg Neurol. 1990;34:79–86.CrossRefPubMedGoogle Scholar
- 26.Kobayashi T, Kida Y, Mori Y. Stereotactic gamma radiosurgery for pineal and related tumors. J Neurooncol. 2001;54:301–9.CrossRefPubMedGoogle Scholar
- 27.Mori Y, Kobayashi T, Hasegawa T, et al. Stereotactic radiosurgery for pineal and related tumors. Prog Neurol Surg. 2009;23:106–18.CrossRefPubMedGoogle Scholar
- 28.Hasegawa T, Kondziolka D, Hadjipanayis CG, et al. Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases. Pediatr Neurosurg. 2003;38:329–33.CrossRefPubMedGoogle Scholar
- 29.Lekovic GP, Gonzalez LF, Shetter AG, et al. Role of Gamma Knife surgery in the management of pineal region tumors. Neurosurg Focus. 2007;23:E12.CrossRefPubMedGoogle Scholar
- 30.Wilson DA, Awad AW, Brachman D, et al. Long-term radiosurgical control of subtotally resected adult pineocytomas. J Neurosurg. 2012;117:212–7.CrossRefPubMedGoogle Scholar
- 31.Yianni J, Rowe J, Khandanpour N, et al. Stereotactic radiosurgery for pineal tumours. Br J Neurosurg. 2012;26:361–6.CrossRefPubMedGoogle Scholar
- 32.Dempsey PK, Lunsford LD. Stereotactic radiosurgery for pineal region tumors. Neurosurg Clin N Am. 1992;3:245–53.PubMedGoogle Scholar
- 33.Deshmukh VR, Smith KA, Rekate HL, et al. Diagnosis and management of pineocytomas. Neurosurgery. 2004;55:349–55.CrossRefPubMedGoogle Scholar