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Central Nervous System
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
The management of pineal tumors includes imaging the entire neuraxis, immediate decompression of hydrocephalus, and establishing a tissue diagnosis. Pineocytoma is a surgical disease and may be cured by total resection. Pineoblastoma is less likely to be cured by surgery, although complete resection should be attempted where possible. There is evidence that whole-neuraxis radiotherapy with the boost directed at the tumor improves outcome, particularly if resection is incomplete. Chemotherapy responses can also be seen. Intermediate (Grade 2/3) tumors present particular difficulties in management. Again, complete surgical excision should be attempted where possible. The need for radiotherapy will depend on the completeness of resection, the mitotic rate, and evidence of dissemination away from the primary.
Anatomical and Biological Imaging of Pediatric Brain Tumor
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Rob A. Dineen, Shivaram Avula, Andrew C. Peet, Giovanni Morana, Monika Warmuth-Metz
Pineocytomas are WHO grade I pineal tumors that are typically well-defined lobulated tumors that are generally uncommon in childhood. These lesions tend to be iso- to hypointense on T1-weighted imaging, moderately hyperintense on T2-weighted imaging, with strong contrast enhancement following administration of GBCA (Figure 5.25a–c). Unlike the higher-grade pineal parenchymal tumors, these tumors do not show diffusion restriction.
Test Paper 3
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Pineocytomas are slow-growing pineal parenchymal neoplasms. At CT they are well demarcated, usually less than 3 cm, and iso- to hyperattenuating. At MR imaging, pineocytomas are well-circumscribed lesions that are hypo- to isointense on T1-weighted images and hyperintense on T2-weighted images. On post-contrast images, they typically demonstrate avid, homogeneous enhancement. Cystic or partially cystic changes may occur, occasionally making differentiation from a pineal cyst difficult. However, at immediate post-contrast imaging, cystic-appearing pineocytomas demonstrate internal or nodular wall enhancement.
Pediatric embryonal brain tumors in the molecular era
Published in Expert Review of Molecular Diagnostics, 2020
Bryan K. Li, Salma Al-Karmi, Annie Huang, Eric Bouffet
PB is a rare but aggressive EBT that arises in the pineal gland, the intracranial neuroendocrine organ that secretes melatonin for the regulation of sleep-wake cycles. Reported in less than 1% of pediatric brain tumors [1], it accounts for a third of tumors that arise from the pineal parenchyma [97]. As other EBTs may also present in the pineal region and share overlapping histology, specific markers to exclude these entities should be performed (loss of SMARCB1/INI1 or SMARCA4/BRG1 for ATRT, and C19MC amplification ± LIN28 expression for ETMR/C19MC-altered tumors). Other lesions arising in the pineal region include lower-grade pineal lesions (pineocytoma, pineal parenchymal tumors of intermediate differentiation/PPTID, and papillary tumor of the pineal region/PTPR), germ cell tumors, and HGGs.
The supracerebellar infratentorial approach in pineal region tumors: Technique and outcome in an underprivileged setting
Published in Alexandria Journal of Medicine, 2018
Mahmoud Abbassy, Khaled Aref, Ahmed Farhoud, Anwar Hekal
Open surgery is still considered the treatment of choice for pineal parenchymal tumors, for adequate tissue acquisition and better progression free survival. In pineocytomas it is considered the treatment of choice with superior progression free survival as regards gross total resection. None of the patient diagnosed with pineocytoma was reported to have a recurrence in the literature, in comparison with 9.5% rate of recurrence after subtotal resection and radiotherapy. Also pineoblastomas have been observed to be associated with prolonged overall survival when grossly resected.12 The rate of major postoperative morbidity is considered to be low, lying between 0 and 5% in several studies.12,13 The reported median overall survival for pineoblastomas is 20 months and 10% 5-year survival.12 None of our surgical cases had any major post-operative complication.
Pure endoscopic resection of pineal region tumors through supracerebellar infratentorial approach with ‘head-up’ park-bench position
Published in Neurological Research, 2023
Wei Hua, Hao Xu, Xin Zhang, Guo Yu, Xiaowen Wang, Jinsen Zhang, Zhiguang Pan, Wei Zhu
There were 14 studies concerning purely endoscopic surgery including 46 cases, as is shown in Table 2 [10,12,14–25]. The GTR and complication rates were 87.0% (40 cases) and 26.1% (12 cases), respectively. There was no mortality and permanent neurological deficits. Twenty-eight cases (from six studies) were operated in prone position, 14 cases (4 studies) were employed prone position, and 4 cases (4 studies) with semi-sitting position. Pineal cysts were the most common tumor type (13 cases, 28.3%), followed by germinomas (10.9%), five teratomas (three immature, two mature), three yolk sac tumors (6.5%), three pineocytomas, three gliomas, and so on.