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Tumors of the Pineal Region

  • Manfred WestphalEmail author
Chapter

Abstract

Tumors of the pineal region include a broad spectrum of histological entities which originate either from the pineal tissue matrix (pineal parenchymal tumors) or from local tissues in that area. Also, germinomatous tumors prefer that location so that this very small anatomical region with its lesions needs interdisciplinary approaches. Hydrocephalus is the main presenting symptom and needs urgent treatment, currently mostly by endoscopic ventriculostomy which also allows in some cases to take a biopsy. Depending on the histology and serum or cerebrospinal fluid markers, some lesions will be treated by nonsurgical means such as radiation or chemotherapy or combinations thereof, predominantly the germinomas but also non-germinomatous germ cell tumors or atypical teratoid rhabdoid tumors which at a later stage may undergo surgery for remnant or second look. Pineal parenchymal tumors are mostly resected with great care to allow for representative histological evaluation to not miss an intermediate differentiation or beginning anaplasia as that requires additional treatment. When completely resected, pineocytomas have an excellent prognosis as do the other tumors with adequate adjuvant treatments.

The spectrum of diseases and their appropriate treatment including a thorough evaluation of different competing/controversial surgical approaches is given and illustrated in this chapter.

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryUniversity of HamburgHamburgGermany

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