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Journal of Neuro-oncology Jun 2000The authors report a case of pineocytoma in a 44-year-old woman suffering from headache, vomiting and Parinaud syndrome. At histopathological examination the neoplasm...
The authors report a case of pineocytoma in a 44-year-old woman suffering from headache, vomiting and Parinaud syndrome. At histopathological examination the neoplasm showed a ill-defined lobulate pattern with some small pineocytomatous rosettes. The electron-microscopy revealed cells of moderate size and oval nuclei with smooth nuclear envelopes; well-developed organelles were found in the, abundant cytoplasm. The chromosome analysis revealed this kariotype: 58-59, XXX, -4, -5, -13, - 14, -15, + 19. This is the first report of a pineocytoma with ultrastructural and cytogenetic study; it confirms the literature findings of the electron-microscopy, whereas there is partial accordance with the previous cytogenetic studies.
Topics: Adult; Aneuploidy; Biomarkers, Tumor; Brain Neoplasms; Cerebrospinal Fluid Shunts; Chromosome Aberrations; Chromosome Deletion; Female; Humans; Karyotyping; Neoplasm Proteins; Phosphopyruvate Hydratase; Pineal Gland; Pinealoma; Synaptophysin; Trisomy
PubMed: 11083076
DOI: 10.1023/a:1006400418607 -
The Journal of Veterinary Medical... Jun 1991
Topics: Animals; Brain Neoplasms; Female; Intercellular Junctions; Microscopy, Electron; Pineal Gland; Pinealoma; Rats; Rats, Inbred Strains; Rodent Diseases; Specific Pathogen-Free Organisms
PubMed: 1832044
DOI: 10.1292/jvms.53.527 -
American Journal of Ophthalmology Dec 1994We examined an 8-year-old girl who had an acquired double elevator palsy and a histopathologically confirmed benign pineocytoma.
PURPOSE/METHODS
We examined an 8-year-old girl who had an acquired double elevator palsy and a histopathologically confirmed benign pineocytoma.
RESULTS/CONCLUSIONS
Mass lesions in the region of the pineal gland can produce monocular blepharoptosis and supranuclear upgaze paresis with the resultant clinical picture of double elevator palsy.
Topics: Blepharoptosis; Brain Neoplasms; Child; Female; Humans; Ophthalmoplegia; Pineal Gland; Pinealoma
PubMed: 7977612
DOI: 10.1016/s0002-9394(14)72565-6 -
Noshuyo Byori = Brain Tumor Pathology Mar 1995Six cases of pineocytoma, which had developed in the parenchyma of the adult pineal body, were examined immunohistochemically and under an electron microscope, after the...
Six cases of pineocytoma, which had developed in the parenchyma of the adult pineal body, were examined immunohistochemically and under an electron microscope, after the malignancy of each case had been determined using our classification. One case was rated as grade 1 showing a lobular structure and resembling the normal pineal body. Two cases were rated as grade 2 without a lobular structure but with pineocytomatous rosettes (P-rosettes). Two cases were rated as grade 3 without P-rosettes but with few mitotic figures. One case was rated as grade 4 with marked cellular pleomorphism, numerous mitotic figures and necrotic foci. When examined immunohistochemically, neuron-specific enolase was positive but glial fibrillary acidic protein was negative in all cases. Under an electron microscope, all cases showed abortive synapses, and clear or dense core vesicles. These findings allow us to make two conclusions. First, pineocytoma is always a tumor of neuronal lineage, regardless of their grade of malignancy. Second, the grade 4 pineocytoma should be distinguished from the type of tumor classically called "pineoblastoma." That is, the former seems to be a biologically dedifferentiated tumor, while the latter seems to be biologically undifferentiated tumor.
Topics: Adult; Brain Neoplasms; Cell Differentiation; Female; Humans; Immunohistochemistry; Male; Microscopy, Electron; Middle Aged; Neurons; Pineal Gland; Pinealoma
PubMed: 7795727
DOI: No ID Found -
Klinicka Onkologie : Casopis Ceske a... 2013Primary intracranial germ cell tumors represent a rare category of neoplasms, which occur in children and young adults. The WHO classification divides intracranial... (Review)
Review
BACKGROUND
Primary intracranial germ cell tumors represent a rare category of neoplasms, which occur in children and young adults. The WHO classification divides intracranial tumors into germinomas and non-germinomas. The most frequent locality of these tumors is pineal and suprasellar region. Clinical signs and symptoms depend on the localization of the tumour - they most commonly include signs of increased intracranial pressure, Parinauds syndrome, bitemporal hemianopsy and signs of endocrine deficiency. Gadolinium enhanced MRI scan of the brain is the imagining examination of choice in the diagnostic strategy of intracranial germ cell tumors. However, the imagining studies do not provide sufficient information about histological type; therefore, biopsy is necessary. The exception represents cases with characteristically increased levels of tumor markers (AFP and β-HCG) measured in the serum and cere-brospinal fluid.
CASE
A pineal germ cell tumor was observed in a 26-year-old male with presentation of an eye-sight disorder with focusing difficulty and photophobia, accompanied by intensive fatigue and sleepiness, nausea with occasional vomiting, intermittent headaches and Parinauds syndrome. MRI examination of the brain showed tumor expansion in the pineal region and in the right part of the mesencephalon. Radical extirpation of the tumor in the pineal region was performed. The follow-up MRI scan of the brain revealed relapse of the disease. The patient underwent craniospinal radiation therapy with subsequent postoperative chemotherapy (regimen cisplatin and etoposide), three cycles in total. Currently, the patient is 30 months after finishing of oncological treatment in clinical remission of the disease.
CONCLUSION
The treatment and prognosis of this neoplasm differ between particular categories. Germinomas have better survival rates than non-germinomas. A 5-year survival rate of germinoma patients after application of radiotherapy alone was > 90% of cases. The addition of chemotherapy lead to a decrease of the dose and minimalization of the irradiated area, with achievement of fewer side effects without a decrease of the curability. Non-germinomas are less radiosensitive than germinomas, but after the application of the adjuvant chemotherapy, survival benefit was achieved. However, the optimal management of these tumors remains controversial.
Topics: Adult; Humans; Male; Neoplasms, Germ Cell and Embryonal; Pinealoma
PubMed: 23528168
DOI: 10.14735/amko201319 -
Cancer Jan 2012For this report, the authors comprehensively summarized the existing literature on patients with pineoblastoma and identified the variables and treatments that had an... (Review)
Review
BACKGROUND
For this report, the authors comprehensively summarized the existing literature on patients with pineoblastoma and identified the variables and treatments that had an impact patient on outcomes.
METHODS
A comprehensive search identified 109 studies that collectively described the outcomes of patients with pineoblastoma. Individual patient data were classified based on treatment and were subjected to univariate comparisons. Cox regression analysis included comparisons of survival outcomes controlling for age, extent of resection, and treatment group, and between-group survival comparisons were performed using the Kendall tau (rank correlation) statistic.
RESULTS
Two hundred ninety-nine patients met inclusion criteria. The overall survival rate was 54% (175 of 299 patients) at a mean follow-up of 31 ± 1.9 months (range, 1-159 months). The analyses demonstrated a markedly worse prognosis for children aged ≤ 5 years compared with older patients (5-year survival rate: 15% for children aged ≤ 5 years vs 57% for children aged ≥ 5 years; log-rank P < .00001). In addition, a graded increase in survival was observed with increasing degrees of resection (5-year survival rate: 84% for patients who underwent gross total resection vs 53% for patients who underwent subtotal resection vs 29% for patients who underwent debulking; log-rank P < .0001). Multivariate analysis indicated that not achieving gross total resection markedly worsened patient survival (subtotal resection: hazard ratio, 6.47; 95% confidence interval, 2.3-19; P = .001. debulking: hazard ratio, 9.27; 95% confidence interval, 3.2-27; P < .0001).
CONCLUSIONS
The current findings emphasize the importance of aggressive surgical resection in the treatment of pineoblastoma. In addition, the authors conclude that clinical trials should not mix young patients with older patients or patients who undergo subtotal resection with patients who undergo gross total resection, because such heterogeneity may alter the variability of responses to treatment and reduce the likelihood of success.
Topics: Adult; Brain Neoplasms; Chemotherapy, Adjuvant; Child; Child, Preschool; Combined Modality Therapy; Female; Humans; Male; Pinealoma; Prognosis; Radiotherapy, Adjuvant; Survival Analysis; Treatment Outcome
PubMed: 21717450
DOI: 10.1002/cncr.26300 -
Turkish Neurosurgery 2015Primary pineal melanoma is a rare tumor. We herein review the histogenesis, pathology, radiology and therapeutic options of this rare tumor. (Review)
Review
AIM
Primary pineal melanoma is a rare tumor. We herein review the histogenesis, pathology, radiology and therapeutic options of this rare tumor.
MATERIAL AND METHODS
We conducted a PUBMED search using a combination of keywords such as "primary pineal melanoma", "CNS melanoma", and "pineal tumor" and identified 16 cases of primary pineal melanoma. Clinical features, pathologic characteristics and treatment details of these patients were noted from respective case reports. We also describe a case of a 45-year-old Indian woman with primary pineal melanoma treated with a combination of surgery and post-op radiation.
RESULTS
The median age at presentation is 50 years. Median duration of symptoms is 6 weeks. Common symptoms at presentation include headache (58.8%), personality changes (41.2%), gait disturbance (35.3%) and Parinaud's syndrome (29.4%). Surgery, radiotherapy and chemotherapy have been used in 29.4%, 47.1% and 23.5% of patients respectively. Median overall survival is 56 weeks. Leptomeningeal dissemination and ventricular ependymal spread were noted in 70.6% and 35.3% patients, respectively.
CONCLUSION
Combined modality treatment comprising maximal safe surgery and post-operative radiation should be preferred in patients with localized pineal melanoma without leptomeningeal dissemination. Taking a cue from other subsites of melanoma, chemotherapy can perhaps be deferred until recurrence.
Topics: Female; Humans; Melanoma; Middle Aged; Pinealoma
PubMed: 26014001
DOI: 10.5137/1019-5149.JTN.6568-12.1 -
Neurology Jul 2016
Topics: Aged; Brain Neoplasms; Humans; Magnetic Resonance Imaging; Male; Pineal Gland; Pinealoma; Supranuclear Palsy, Progressive
PubMed: 27432179
DOI: 10.1212/WNL.0000000000002870 -
Neurosurgery Clinics of North America Jul 2011Pineal tumors are relatively rare central nervous system lesions with a predilection for the pediatric population. For the vast majority of these lesions, surgical... (Review)
Review
Pineal tumors are relatively rare central nervous system lesions with a predilection for the pediatric population. For the vast majority of these lesions, surgical resection is a critical step in effective treatment. This article discusses current strategies for preoperative evaluation, operative management, and postoperative care of the pediatric patient with a newly diagnosed pineal region tumor.
Topics: Adolescent; Child; Child, Preschool; Diagnostic Imaging; Drug Therapy; Female; Germinoma; Humans; Male; Neurosurgical Procedures; Pineal Gland; Pinealoma; Radiotherapy
PubMed: 21801988
DOI: 10.1016/j.nec.2011.05.003 -
Acta Neurochirurgica Apr 2002Although pineal parenchymal tumours are very rare in elderly patients, we recently successfully treated a 72-year-old male patient. Interestingly, the histology of his...
BACKGROUND
Although pineal parenchymal tumours are very rare in elderly patients, we recently successfully treated a 72-year-old male patient. Interestingly, the histology of his pineal parenchymal tumour was mixed pineocytoma/pineoblastoma, which is reported to be extremely rare in aged patients. We present his clinical manifestations, follow-up MRI, surgical treatment, pathological findings, and review the literature.
CLINICAL MATERIAL
This 72-year-old man had a mass in the pineal region detected 3 years previously on MRI in February 1996 following symptoms of headache and vertigo. Two years later, he experienced gait disturbance and disorientation. CT scans disclosed obstructive hydrocephalus, and ventriculo-peritoneal shunt placement was then performed. The tumour mass began to enlarge in July 1999 (at age 72). On October 13, 1999, total removal of the pineal region tumour was performed through an occipital transtentorial approach. The postoperative course was uneventful. The pathological diagnosis of the tumour was mixed pineocytoma/pineoblastoma.
CONCLUSION
Pineal parenchymal tumours are uncommon in elderly patients, and mixed pineocytoma/pineoblastomas are particularly rare. We followed this patient closely for more than 3.5 years and finally performed total surgical removal of the tumour, with excellent outcome. The present case suggests that a mixed pineocytoma/pineoblastoma tumour is controllable even in elderly patients through careful evaluation and management.
Topics: Aged; Brain Neoplasms; Headache; Humans; Hydrocephalus; Magnetic Resonance Imaging; Male; Pineal Gland; Pinealoma; Tomography, X-Ray Computed; Treatment Outcome; Vertigo
PubMed: 12021888
DOI: 10.1007/s007010200055