Pineal tumours in the north of England 1968-93.

Abstract

The records of 38 patients under 25 years of age presenting with pineal tumours between 1968 and 1993, identified from the Northern Region Children's and Young Adults' Malignant Disease Registry, were analysed retrospectively with regards to clinical presentation, diagnostic approach, treatment strategy, and outcome. The overall five year survival was 45%. Fifteen patients had a histological diagnosis: six with germinomas, three with teratomas, three with astrocytomas, and three with pinealoblastomas. One patient had a definitive diagnosis of teratoma made on the basis of raised tumour markers (a fetoprotein). Treatment consisted of surgery (87%) (ventriculoperitoneal or atrial shunt andlor biopsy), and/or radiotherapy (82%), and/or chemotherapy (26%). Those patients with a tissue diagnosis appeared to have a more favourable outcome, especially after 1976 when treatment was determined by tumour type (five year survival for those with a tissue diagnosis was 91% v 51% for those without, 95% confidence intervals 74 to 100% and 26 to 75%).This study suggests that tissue diagnosis allows more appropriate treatment to be delivered for children with pineal tumours resulting in improved survival. Referral to a centre with neurosurgery, radiotherapy, neuropathology, and paediatric oncology collaboration is essential.

Glioblastoma multiforme of the pineal region: case report

“…The tumors of the pineal region are uncommon, ranging from 0.5 to 2% of all intracranial neoplasms in several review papers 3,5,6,14 . The origin of the tumors of this region can be the pineal gland itself, the posterior portion of the third ventricle and the quadrigemina cistern.…”

“…Edema, hemorrhage and contrast enhancement are common features. Nonneoplastic processes that may also simulate a pineal tumor at this location include epidermoid, dermoid and glial cysts 3,4,7,14 .…”

“…The three major categories are germ cell tumors, parenchymal cell tumors, and the supporting tissues neoplams (glial tumors). Germinomas are the most common histological type, comprising 50-60% of all pineal tumors 3,4 . Gliomas account for 33% of pineal neoplams, but are mainly low grade astrocytomas 1,4 .…”

Primary pineal glioblastoma: a case report

“…Tumors of this region are rare and make up less than 1% of all intracranial tumors (1,6). Tumors can be derived from the pineal gland itself, germ cells as in germinomas, and teratomas and supporting tissue as in gliomas.…”

“…The second most frequent type is glial tumor but is mostly low grade glioma and the third is parenchymal tumors such as pineocytoma or pineoblastoma (1). Glioblastoma (GBM) is rare in this region (6,12,16).…”