Surgical treatment of a rare rosette-forming glioneuronal tumor in the pineal region

Abstract

Background: Rosette-forming glioneuronal tumors (RGNTs) in the pineal region are rare. RGNTs have been described in the fourth ventricle, but rarely reported in other brain regions. Here, we report the radiological findings, surgical treatment, and short-term outcome of an RGNT found in the pineal region. Case Description: We present a case of a 22-year-old medical student with a 4-month history of headaches and diplopia. A previous magnetic resonance imaging scan revealed a mass in the pineal region, with heterogeneous contrast enhancement and hydrocephalus. Three months prior, an endoscopic biopsy and third ventriculocisternostomy were performed elsewhere; the diagnosis was neurocytoma Grade I, and radiotherapy was planned. The patient presented at our hospital for a second opinion, and we suggested surgical treatment. A near-total resection was performed in sitting position using a supracerebellar infratentorial microsurgical approach. The tumor was very soft and not well vascularized. Diplopia was initially worsened after the tumor was removed and relieved completely after 2 weeks. An 8-week follow-up examination revealed that the patient was free of symptoms. Histological analysis confirmed it was an RGNT. Conclusion: Maximal safe resection in pineal region RGNTs is a feasible and recommended treatment option.

SARS-CoV-2 infection increases risk of intracranial hemorrhage

“…Our clinical correlative study provides new evidence for the association of COVID-19 to a hither comparatively unreported severe clinical complication, namely, bleeding of intracranial blood vessels. Our work further supports previous observations of others, such as endothelial cell infection and endotheliitis in COVID-19 patients (Varga et al, 2020), SARS-CoV-2 infected patients associated with stroke (Dhamoon et al, 2021), intracerebral hemorrhage (Cheruiyot et al, 2021), and CNS vasculitis, as well as our own previous experiences of coexisting SARS-CoV-2 infection and subarachnoid hemorrhage (Muhammad et al, 2020). This study further warns to monitor SARS-CoV-2 infected people for possibly the early onset of intracerebral bleeding and indicates the need to deeper investigate the interaction of the virus with the vascular system.…”

Clinicopathological analysis of rosette-forming glioneuronal tumors

“…It is generally believed that RGNT often occurs in the fourth ventricle, cerebellar vermis, cerebellar hemisphere, and adjacent regions. Instances of tumors found in the spinal cord, thalamus, pons, optic chiasma area, tegmental area, pineal body, and cases with multiple intracranial space-occupying lesions have been documented, with few patients also presenting with type I neurofibromatosis [ 6 – 11 ]. In our study involving six RGNT cases, three were situated in the fourth ventricle or cerebellum, one in the quadrigeminal cistern, one in the third ventricle, and another exhibited multiple space-occupying lesions involving the brainstem, fourth ventricle, cerebellum, and bilateral thalamus.…”