Pineal Region Tumors and the Role of Stereotactic Biopsy: Review of the Mortality, Morbidity, and Diagnostic Rates in 370 Cases

Régis, Jean; Bouillot, P.; Rouby-Volot, Françoise; Figarella‐Branger, Dominique; Dufour, Henry; Peragut, J. C.

doi:10.1097/00006123-199611000-00003

Cited by 86 publications

(57 citation statements)

References 40 publications

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“…In addition, no central pathology review was done, so the diagnosis of the referring institution was used as submitted, a factor that has proven to be of importance in the practice of neuropathology [25]. Although other studies have included larger data sets than ours, those studies were either dedicated to CGTs only [19, 26] or were interested in surgical description only [27, 28]. Thus, this paper is unique in that it presents analyses of survival and the impact of radiotherapy, histology, and the extent of surgical resection on survival.…”

Section: Discussionmentioning

confidence: 99%

Pineal gland tumors: experience from the SEER database

et al. 2009

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Pineal gland tumors are rare and account for less than 1% of all primary brain tumor diagnoses. Also, they are more commonly seen in pediatric patients than in adults. We analyzed the available SEER data on pineal gland tumors that were diagnosed during the period 1973–2005. The cohort was subdivided into groups on the basis of tumor histology: germ cell tumors, pineal parenchymal tumors, gliomas, and other pineal tumors. Analyses of incidence, survival, factors influencing survival, and treatment modality are provided. Among the 633 patients with pineal tumors, male sex was predominant, i.e., sex ratio was 3:1 for the whole group and 11.8:1 for those with germ cell tumors. The 5-year overall survival (OS) for the cohort was 65% ± 2.1%. Those with germ cell tumors experienced the best survival (OS = 78.9% ± 2.3%), followed by those with gliomas (OS = 61% ± 9.3%), and those with pineal parenchymal tumors (OS = 47.2% ± 4.2%). Non–germ cell tumors, no radiotherapy, and diagnosis before 1993 were the only factors associated with a negative impact on survival. The extent of surgical tumor resection did not affect survival in any histologic subgroup. We conclude that although pineal tumors are histologically diverse, they share some similarities due to their unique location. An aggressive surgical approach should be considered with caution in this region. Further studies on different pineal tumors subtypes are needed.

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Section: Discussionmentioning

confidence: 99%

Pineal gland tumors: experience from the SEER database

et al. 2009

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“…Whenever possible, stereotactic biopsy should be performed as a less-invasive way to obtain the tissue samples needed for histopathology. [19]…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis simulating brain tumor

Isolan¹,

Vieira²,

Hehn³

et al. 2014

Surg Neurol Int

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Background:Paracoccidioidomycosis (PCM) is a systemic granulomatous disease caused by Paracoccidioides brasiliensis. Involvement of the central nervous system (CNS) occurs in about 10% of cases.Case Description:A 57-year-old white man presented with the complaint of headache and an episode of focal seizure 1 month earlier. Magnetic resonance imaging (MRI) revealed a ring-enhancing lesion in the right parietal lobe with peri-lesional vasogenic edema suggestive of a primary neoplasm. The patient underwent craniotomy and the intraoperative finding was a yellowish, hard lesion with thick content and yellow inside. Anatomo-pathological findings were pathognomonic of PCM: large, thick-walled, spherical yeast cells with multiple peripheral buds. The patient tested negative for human immunodeficiency virus (HIV). Encephalitis and meningitis were ruled out by cerebrospinal fluid analysis. Culture confirmed the diagnosis of PCM and the patient was treated with amphotericin B. The patient responded well to treatment with resolution of the headache and clinical improvement, despite a bitemporal hemianopia. He was clinically stable and then discharged in good general condition.Conclusions:Radiographic findings of PCM with CNS involvement may suggest neoplasia, making diagnosis difficult. In endemic areas, the diagnosis of PCM should be promptly considered when a ring-enhancing mass associated with peri-lesional edema is observed on MRI.

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“…In contrast to resection, stereotactic biopsy of pineal region tumors has been reported to have a lower risk of complications. A series of 370 patients reported a mortality rate of 1.3% and a major morbidity rate of 0.81% [9], another series of 88 patients revealed neither permanent mortality nor morbidity, with a transient morbidity of 6% and a diagnostic yield of 99%, although one case required three distinct stereotactic procedures to establish diagnosis [10]. …”

Section: Discussionmentioning

confidence: 99%

Stereotactic Radiosurgery of a Papillary Tumor of the Pineal Region: Case Report and Review of the Literature

Riis¹,

Eck²,

Dunker

et al. 2013

Stereotact Funct Neurosurg

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Background/Aims: Papillary tumors of the pineal region are a recently described very rare group of primary CNS neoplasms. Because of their rarity, it has proven to be difficult to establish the optimal therapy. Furthermore, microsurgical resection of pineal region neoplasms is associated with quite a high morbidity. We report the first case of stereotactic radiosurgery of a histologically confirmed papillary tumor of the pineal region. Methods: After establishing the diagnosis by stereotactic biopsy, the patient was treated with stereotactic radiosurgery in a Gamma Knife unit. Results: Five years after treatment, the tumor size is still decreasing, showing a good response to the treatment. Conclusions: Stereotactic radiosurgery should be considered a treatment option in these surgically challenging tumors.

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Pineal Region Tumors and the Role of Stereotactic Biopsy: Review of the Mortality, Morbidity, and Diagnostic Rates in 370 Cases

Abstract: Our conclusion is that stereotactic biopsy must remain a main diagnostic modality for tumors of the pineal region.

Cited by 86 publications

References 40 publications

Pineal gland tumors: experience from the SEER database

Pineal gland tumors: experience from the SEER database

Paracoccidioidomycosis simulating brain tumor

Stereotactic Radiosurgery of a Papillary Tumor of the Pineal Region: Case Report and Review of the Literature

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