Pineal Parenchymal Tumor with Intermediate Differentiation Treated with Radio-Chemotherapy: First Case Report in Our Institution

Abstract

P ineal parenchymal tumor with intermediate differentiation (PPTID) is an extremely uncommon tumor in Thailand. A young Thai woman presented at the hospital with visual problems and clinical hydrocephalus. There is no treatment protocol for PPTID as yet. The purpose of this study is to determine specific management guidelines for a multidisciplinary team to follow. Case Report A 47-year-old Thai female presented with worsening diplopia and headache, with no improvement with eyeglasses for a couple of months. The patient came to hospital for an investigation, and computed tomography (CT scan) and magnetic resonance imaging (MRI) of the brain was performed, and showed a 5cm mass at the pineal region with obstructive hydrocephalus. The differential diagnosis from brain imaging was a pineal tumor in origin with risk of cerebrospinal fluid (CSF) metastases (Figure 1). This was followed by an MRI of the spine that found multiple enhancing nodules in the thecal sac (Figure 2).