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

Bechri, Hajar; Oudrhiri, Mohammed Yassaad; Louraoui, Sidi Mamoun; Melhaoui, Adyl; Sefiani, S.; Arkha, Yasser; Ouahabi, Abdessamad El

doi:10.25259/sni_613_2020

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…Findings suggest that the safety of GKSRS can be improved by actively dealing with hydrocephalus prior to radiosurgical treatment. Bechri et al published a case report on a patient with a papillary tumor of the pineal region presenting with obstructive hydrocephalus; the patient underwent ETV, which showed improvement of initial symptoms, the disappearance of nausea and vomiting, and only slight improvement in visual symptoms [ 18 ]. The tumor was treated with GK ICON with a dose of 14 Gy at a 50% isodose and the patient was followed up at three, six, and 12 months thereafter.…”

Section: Discussionmentioning

confidence: 99%

“…The tumor was treated with GK ICON with a dose of 14 Gy at a 50% isodose and the patient was followed up at three, six, and 12 months thereafter. During follow-up, the neurological examination showed progressive improvement until showing complete resolution of symptoms after radiosurgical treatment; tumor reduction and aqueduct compression disappeared after six months [ 18 ]. Zhang et al [ 19 ] argued on the existing controversial management regarding when and how to treat hydrocephalus secondary to pineal region tumors.…”

Section: Discussionmentioning

confidence: 99%

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Upfront Radiosurgery for Treatment of Symptomatic Obstructive Hydrocephalus due to Brain Tumors

Moreira¹,

Rodezno²,

Santos³

et al. 2022

Cureus

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IntroductionHydrocephalus is a build-up of cerebrospinal fluid (CSF) in the brain and is characterized by abnormal dilatation of the cerebral ventricles. Patients can be either asymptomatic, have symptoms related to primary tumors, or have hydrocephalus-related symptoms. Generally, symptomatic patients are candidates for ventriculoperitoneal (VP) shunt placement to reduce acute symptoms. Little evidence exists regarding the resolution of symptomatic hydrocephalus secondary to brain tumors using stereotactic radiosurgery (SRS) alone as a primary treatment option. MethodsThe present study is a retrospective series of eight patients (six men and two women) diagnosed with obstructive hydrocephalus due to brain tumors treated with radiosurgery between April 2013 and February 2021. The primary endpoint of the present study is to report our institutional experience regarding the control of symptomatic obstructive hydrocephalus due to brain tumors treated with upfront radiosurgery. ResultsThe mean age was 52 years (range, 5-79). The most common presenting symptoms included headache (100%), vision-related symptoms (75%), and ataxia (37.5%). All patients showed symptom improvement after radiosurgery, five (62.5%) patients showed resolution in less than three days and the rest of the patients resolved hydrocephalus in a longer timeframe (more than three days). All patients lowered their Evans index compared to the index documented before radiosurgery, in a range from 0.02 to 0.17. ConclusionRadiosurgery is a non-invasive alternative treatment for primary and secondary brain tumors that debut with obstructive hydrocephalus, tumors expected to have a high alpha/beta ratio might be suitable to attempt radiosurgery to avoid permanently implanted devices such as VP shunts or other invasive procedures such as a third ventriculostomy. The present study demonstrated that in selected cases SRS can lead to hydrocephalus symptom resolution along with a decrease in ventricular size in a relatively short time frame. Little evidence exists regarding the effect of SRS on symptomatic hydrocephalus resolution and further histology-specific studies are required. We acknowledge that this approach requires immediate access to radiosurgery and close clinical follow-up to ensure success.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Upfront Radiosurgery for Treatment of Symptomatic Obstructive Hydrocephalus due to Brain Tumors

Moreira¹,

Rodezno²,

Santos³

et al. 2022

Cureus

View full text Add to dashboard Cite

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Determination of Optimal Treatment Plan for Papillary Tumor of the Pineal Region: Case Series With Literature Review

Pang,

Mazur-Hart,

Yaghi

et al. 2024

Brain Tumor Res Treat

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Background Papillary tumor of the pineal region (PTPR) is a rare neuroepithelial tumor with Central Nervous System (CNS) World Health Organization (WHO) grade II or III classification. Due to its rarity, there is no clear census on treatment. The purpose of this study is to identify the optimal treatment plan focused on extending overall survival (OS). Methods This is an institutional case series with review of the literature. Fifty-three publications were analyzed. Only cases with histological diagnosis of PTPR were included. Data collected included demographics, treatment modalities, disease progression, and OS. Results The analysis included 105 patients from the literature and 3 new cases (54 female, 50%) with an average age of 33.1 years (range 1–73 years). The average lesion size was 26.4 mm (range 5–50 mm) in longest axis. All patients underwent an initial resection. There were 46 cases of surgery alone. The remaining cases received adjuvant therapy including radiation (RT), stereotactic radiosurgery (SRS), chemotherapy (CT), or RT and CT. The average follow-up was 61.4 months (range 1–240 months). OS at 1 year was 96.9%, at 5 years was 87.5%, and at 10 years was 80.2%. Overall progression-free survival (PFS) was 57.4%. Statistical significance was observed in PFS in the surgery plus SRS group and surgery plus CT and RT group. Surgery with SRS had the best PFS (75%), and OS at 1 year (100%) and 5 years (88.9%). Surgery with CT and RT had the best OS at 10 years (85.7%). Conclusion We describe a case series and literature review of PTPR to help guide the most effective treatment strategies for this rare disease entity. We recommend surgery followed by SRS as the treatment of choice because of its best PFS and 5-year survival rates. We would also recommend adding chemotherapy in the event of disease progression or recurrence as adjuvant radiation and chemotherapy provided the best 10-year survival.

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

Cited by 2 publications

References 16 publications

Upfront Radiosurgery for Treatment of Symptomatic Obstructive Hydrocephalus due to Brain Tumors

Upfront Radiosurgery for Treatment of Symptomatic Obstructive Hydrocephalus due to Brain Tumors

Determination of Optimal Treatment Plan for Papillary Tumor of the Pineal Region: Case Series With Literature Review

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