Outcomes After Surgery and Radiotherapy for Papillary Tumor of the Pineal Region

Edson, Mark A.; Fuller, Gregory N.; Allen, Pamela K.; Levine, Nicholas B.; Ghia, Amol J.; Mahajan, Anita; Brown, Paul D.; DeMonte, Franco; Li, Jing

doi:10.1016/j.wneu.2015.02.031

Cited by 24 publications

(5 citation statements)

References 16 publications

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“…The same study has also reported an average progression-free survival of around 5 years. Adjuvant RT offers substantial local control in appropriate cases[ 13 ] and hence may be offered to patients with subtotal resection or if the lesion pathologically shows a high mitotic count (≥3/10 hpf) with a high MIB-1 index (≥10%). Adjuvant chemotherapy or targeted therapy in the form of bevacizumab (antibody against vascular endothelial growth factor)[ 14 ] must be reserved for patients with recurrence or proven metastasis.…”

Section: Discussionmentioning

confidence: 99%

Recurrent papillary tumor of pineal region misdiagnosed as pineocytoma 9-years ago

2021

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Primary tumors of the pineal gland occur infrequently with a preponderance of either parenchymal tumors or germ cells tumors. Papillary tumor of the pineal region is a rare neuroepithelial lesion that arises exclusively in the pineal region. They have been designated as either Grade II or Grade III lesions as per the 2016 WHO classification of central nervous system tumors. Clinically, they usually present with obstructive hydrocephalus and visual disturbance. On imaging, these tumors are solid-cystic, heterogeneously enhancing, and show T2 hyperintensity. Pathologically, they can closely resemble a Grade I pineocytoma and immunohistochemistry is essential to differentiate the two. No definite guidelines exist to confirm the ideal protocol of treatment. Evidence regarding the role of radiation after surgery is limited to case reports and series. Adjuvant therapy is usually recommended for tumors with subtotal excision, high proliferative/mitotic index, or proven metastasis. We describe a case of a 29-year-old male with a recurrent papillary tumor of the pineal region, 9 years after primary surgery where it was misdiagnosed as a pineocytoma. The tumor was effectively controlled with surgical excision, cerebrospinal fluid diversion, and adjuvant radiation for 8 years before showing two recurrences within a span of 6 months with a rising proliferation index.

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Section: Discussionmentioning

confidence: 99%

Recurrent papillary tumor of pineal region misdiagnosed as pineocytoma 9-years ago

2021

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“…Using focal radiotherapy followed by craniospinal irradiation or whole ventricular intensity-modulated radiation therapy, side effects were observed on cognition and quality of life. [ 3 ]…”

Section: Discussionmentioning

confidence: 99%

Papillary tumor of the pineal region: Is stereotactic radiosurgery efficient for this rare entity?

Bechri¹,

Oudrhiri²,

Louraoui

et al. 2021

Surgical Neurology International

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Background: Papillary tumors of the pineal region are rare neuroepithelial lesions that were described for the 1st time in the WHO 2007 classification. Management of such lesions remains controversial. Case Description: We describe the case of a 26-year-old female who presented with intracranial hypertension syndrome secondary to a 1.9 cm3 lesion of the pineal region causing hydrocephalus. The patient benefited from an endoscopic third ventriculocisternostomy and a biopsy of her lesion in favor of a papillary tumor of the pineal region. After discussion of the surgical risks, the patient refused the surgical option and a stereotactic radiosurgery (SRS) was performed. She improved both clinically (allowing her to regain autonomy) and radiologically (reduction of 60% of tumor volume) at 1 year follow-up. Conclusion: Because of the rarity of the lesion, literature is yet not able to find consensus concerning management of such lesion, but SRS has proven efficiency for these Grades II or III lesions with high recurrence rates. Therefore, it should be considered as a primary therapeutic option allowing good outcome with low risks for the patient.

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“…The most prevalent pineal tumors are pineocytomas, pineoblastomas and primitive neuroectodermal tumors (PNET) [ 3 , 4 , 5 , 6 , 7 , 8 ]. In addition, glioblastomas [ 9 , 10 ], metastatic tumors [ 11 , 12 ], vascular malformations [ 13 ], papillary tumors [ 14 ], meningiomas [ 5 , 16 ] and neurocytomas [ 17 , 18 ] can also occur.…”

Section: Introductionmentioning

confidence: 99%

Keyhole surgery of pineal area tumors - personal experience in 22 patients

Kotwica

Saracen

Kasprzak

2017

Translational Neuroscience

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BackgroundPineal area tumors are challenging for surgery due to their location. However, the removal of the lesion is critical for further treatment and survival of the patientsMaterial and methods22 patients with pineal area tumors were surgically treated via keyhole medial suboccipital craniotomy and supracerebellar midline approach All the patients were operated in the sitting position with the use of operating microscope and microsurgical technique.ResultsAll patients survived surgery in a perfect condition, and no one patient worsened after surgery. No complications due to the sitting position were noted.ConclusionsSurgical removal of pineal area tumors via small suboccipital craniotomy is safe and with the use of microsurgical techniques the results of surgical treatment are excellent. The sitting position of the patients gives a better view to the surgeon. We did not observe any intraoperational complications due to the sitting position.

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Outcomes After Surgery and Radiotherapy for Papillary Tumor of the Pineal Region

Cited by 24 publications

References 16 publications

Recurrent papillary tumor of pineal region misdiagnosed as pineocytoma 9-years ago

Recurrent papillary tumor of pineal region misdiagnosed as pineocytoma 9-years ago

Papillary tumor of the pineal region: Is stereotactic radiosurgery efficient for this rare entity?

Keyhole surgery of pineal area tumors - personal experience in 22 patients

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