Tackling a Recurrent Pinealoblastoma

Abstract

Pineoblastomas are rare, malignant, pineal region lesions that account for <0.1% of all intracranial tumors and can metastasize along the neuroaxis. Pineoblastomas are more common in children than in adults and adults account for <10% of patients. The management of pinealoblastoma is multimodality approach, surgery followed with radiation and chemotherapy. In view of aggressive nature few centres use high dose chemotherapy with autologus stem cell transplant in newly diagnosed cases but in recurrent setting the literature is very sparse. The present case represents the management of pinealoblastoma in the recurrent setting with reirradiation and adjuvant carmustine chemotherapy wherein the management guidelines are not definitive.

Isolation and characterization of tumorspheres from a recurrent pineoblastoma patient: Feasibility of a patient-derived xenograft

“…1C) (36), thereby increasing the isotropic component in diffusion tensor imaging (DTI) (37). Some studies have shown that PBs can invade the surrounding brain parenchyma (38,39) and may disseminate through the cerebrospinal fluid (40,41). However, we were unable to find many studies showing radiologically infiltrative PBs, suggesting that PBs with invasiveness comparable to that of GBMs are rare.…”

Development and Validation of a Prognostic Nomogram to Predict Cancer-Specific Survival in Adult Patients With Pineoblastoma

“…To date, therapeutic management of adults with PBs is controversial since such few cases exist in the literatures. Multimodality therapy (surgery, RT, and CT) is often attempted and appears to be the optimal approach (43). In the United States, standard treatment of patients with PB currently includes maximal surgical resection followed by adjuvant cranial-spinal irradiation and systemic chemotherapy (43).…”

“…Multimodality therapy (surgery, RT, and CT) is often attempted and appears to be the optimal approach ( 43 ). In the United States, standard treatment of patients with PB currently includes maximal surgical resection followed by adjuvant cranial–spinal irradiation and systemic chemotherapy ( 43 ). It was reported that the median progression-free survival rate was 4 months in infants and children under 3 years of age who were treated according to infant brain tumor protocols with intensive chemotherapy alone ( 33 ).…”

Management dilemmas in pineoblastoma recurrence diagnosed during pregnancy

“…Recurrences reported in the earlier series are treated primarily with CSI and a combination with chemotherapy may be tried. 30,31 However, since there are no reports before this index case, presenting with a recurrence in pregnancy, the discussion of the multidisciplinary team (MDT) weighing the various options was crucial.…”