Osseous metastasis of pineoblastoma: a case report and review of the literature

Constantine, C. E.; Miller, Douglas C.; Gardner, Sharon; Balmaceda, Casilda; Finlay, Jonathan L.

doi:10.1007/s11060-004-5178-1

Cited by 16 publications

(17 citation statements)

References 8 publications

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“…Our search resulted in 109 publications 1, 3, 4, 7, 10, 17‐61. amounting to 299 nonduplicated, diaggregated patients who were treated for pineoblastoma (see Fig.…”

Section: Resultsmentioning

confidence: 99%

The long‐term postsurgical prognosis of patients with pineoblastoma

Tate

Sughrue

Rutkowski

et al. 2011

Cancer

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BACKGROUND: For this report, the authors comprehensively summarized the existing literature on patients with pineoblastoma and identified the variables and treatments that had an impact patient on outcomes. METHODS: A comprehensive search identified 109 studies that collectively described the outcomes of patients with pineoblastoma. Individual patient data were classified based on treatment and were subjected to univariate comparisons. Cox regression analysis included comparisons of survival outcomes controlling for age, extent of resection, and treatment group, and between-group survival comparisons were performed using the Kendall tau (rank correlation) statistic. RESULTS: Two hundred ninety-nine patients met inclusion criteria. The overall survival rate was 54% (175 of 299 patients) at a mean follow-up of 31 AE 1.9 months (range, 1-159 months). The analyses demonstrated a markedly worse prognosis for children aged 5 years compared with older patients (5-year survival rate: 15% for children aged 5 years vs 57% for children aged !5 years; log-rank P < .00001). In addition, a graded increase in survival was observed with increasing degrees of resection (5-year survival rate: 84% for patients who underwent gross total resection vs 53% for patients who underwent subtotal resection vs 29% for patients who underwent debulking; logrank P < .0001). Multivariate analysis indicated that not achieving gross total resection markedly worsened patient survival (subtotal resection: hazard ratio, 6.47; 95% confidence interval, 2.3-19; P ¼ .001. debulking: hazard ratio, 9.27; 95% confidence interval, 3.2-27; P < .0001). CONCLUSIONS: The current findings emphasize the importance of aggressive surgical resection in the treatment of pineoblastoma. In addition, the authors conclude that clinical trials should not mix young patients with older patients or patients who undergo subtotal resection with patients who undergo gross total resection, because such heterogeneity may alter the variability of responses to treatment and reduce the likelihood of success. Cancer 2012;118:173-

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“…Our search resulted in 109 publications 1, 3, 4, 7, 10, 17‐61. amounting to 299 nonduplicated, diaggregated patients who were treated for pineoblastoma (see Fig.…”

Section: Resultsmentioning

confidence: 99%

The long‐term postsurgical prognosis of patients with pineoblastoma

Tate

Sughrue

Rutkowski

et al. 2011

Cancer

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“…Lumbar puncture and MRI of the neuroaxis are required at the time of diagnosis and in surveillance [12••,14,18]. Pineoblastoma may also metastasize extracranially, with bone being the most common site of metastasis [19]. PPTID are generally closer in behavior and prognosis to pineoblastomas than to pineocytomas, with 165-month median survival [12••]; hence, these tumors are generally treated similarly to pineoblastomas.…”

Section: Overview: Pineal Region Tumor Types Germ Cell Tumorsmentioning

confidence: 99%

“…Some authors suggest that high-grade histology portends a worse prognosis, consistent with supratentorial gliomas [20]. Indeed, a review of the few cases of pineal region glioblastoma multiforme in the literature (roughly 19) shows survival ranging from 2 to 11 months [24]. However, other series report good long-term outcomes for all histologic subtypes [23].…”

Section: Overview: Pineal Region Tumor Types Germ Cell Tumorsmentioning

confidence: 99%

Management of pineal region tumors

Blakeley

Grossman²

2006

Curr. Treat. Options in Oncol.

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Tumors of the pineal region represent a diverse collection of tumors with a variety of natural histories. This diversity necessitates accurate histologic diagnosis to allow rational therapeutic planning. Evaluation of a pineal lesion should begin with craniospinal MRI and analysis of the cerebrospinal fluid (CSF). Whereas certainty of the histologic diagnosis is now a requirement for treatment in Western nations, some Asian centers continue to recommend a test dose of radiation therapy based on the high incidence of germinoma in those countries. If there is high clinical suspicion of a germinoma or tectal glioma, stereotactic or endoscopic biopsy may be pursued. All other lesions should be referred for open biopsy with microsurgical techniques. This approach provides adequate tissue for diagnosis, may be curative in low-grade tumors, and may substantially improve survival in patients with malignant tumors. If open surgery is not desired by the patient or practitioner, stereotactic or endoscopic biopsy may be followed by radiosurgery for localized, well-demarcated tumors. Radiation therapy is the first-line therapy for germinomas. Although the optimal radiation dosage and volume have not been decided, the current Children's Oncology Group trial may offer definitive evidence to address this dilemma in germ cell tumors. Evidence of CSF seeding requires craniospinal radiation and adjuvant chemotherapy regardless of tumor type. Diagnosis of any of the malignant tumors (non-germ cell tumors, pineoblastomas, and parenchymal tumors of intermediate determination) also requires craniospinal radiation (with local tumor doses of at least 50 Gy) and adjuvant chemotherapy (generally platinum based). Patients with tectal gliomas may undergo excision with or without postoperative radiation; however, they also may be observed with vigilant follow-up alone.

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“…Pineoblastoma is an aggressive (WHO IV) pineal parenchymal tumor that may seed the craniospinal axis and metastasize outside the CNS, particularly to bone (Constantine et al 2005). Peritoneal seeding following ventriculoperitoneal shunting has also been reported (Gururangan et al 1994), as well as implantation following stereotactic biopsy (Rosenfeld et al 1990).…”

Section: • Astroblastomamentioning

confidence: 99%