-
Cancer Aug 1993Pineal parenchymal tumors are rare; therefore, only limited clinical data regarding their behavior is available. This study was performed to provide further information... (Review)
Review
BACKGROUND
Pineal parenchymal tumors are rare; therefore, only limited clinical data regarding their behavior is available. This study was performed to provide further information regarding the pathologic features, clinical behavior, and response to therapy of these tumors.
METHODS
This study includes data concerning 30 patients (15 male and 15 female patients) with pineal parenchymal tumors (PPT) diagnosed between 1939 and 1991. Based on gross and microscopic features, tumors were divided into four groups: pineocytomas (9); PPT with intermediate differentiation (4); mixed PPT exhibiting elements of both pineocytoma and pineoblastoma (2); and pineoblastomas (15). At the time of diagnosis, four patients had evidence of spinal seeding (two with pineoblastoma, two with PPT with intermediate differentiation). Twenty-two patients received radiation therapy (RT): 6 were treated to local fields, 7 to the whole brain, and 9 to the craniospinal axis.
RESULTS
For patients who received RT and had a minimum follow-up of 6 months, local failure occurred in one of four patients with pineocytomas, zero of four patients with PPT with intermediate differentiation, one of two with mixed PPT, and four of nine (44%) with pineoblastomas. In patients receiving > or = 50 Gy to the primary tumor, 0 of 12 had local failure compared with 6 of 7 (86%) patients receiving lesser doses. Leptomeningeal failure occurred in zero of four patients with pineocytomas, zero of four patients with PPT with intermediate differentiation, one of two with mixed PPT, and four of nine with pineoblastomas. All leptomeningeal failures occurred in patients with persistent primary tumor. Of the patients with seeding tumors (PPT other than pineocytomas) one of seven (14%) developed leptomeningeal failure when treated with craniospinal irradiation, compared with four of eight (50%) treated to lesser volumes. The projected 1-year, 3-year, and 5-year survival rates of patients with pineocytomas were 100%, 100%, and 67%, and were 88%, 78%, and 58% for those with the other forms of PPT, respectively.
CONCLUSIONS
RT recommendations are described in detail and include the use of doses of > or = 50 Gy to areas of gross disease and the administration of craniospinal irradiation in patients with tumors prone to seeding. Surgical, chemotherapeutic, and pathologic considerations are discussed.
Topics: Adolescent; Adult; Aged; Brain Neoplasms; Child; Child, Preschool; Combined Modality Therapy; Dose-Response Relationship, Radiation; Female; Humans; Infant; Male; Middle Aged; Pineal Gland; Pinealoma; Survival Rate
PubMed: 8334641
DOI: 10.1002/1097-0142(19930801)72:3<870::aid-cncr2820720336>3.0.co;2-x -
Pediatric Blood & Cancer Apr 2022Pineal anlage tumor is a rare pediatric tumor with clinical and histological features overlapping with pineoblastoma. Two patients with pineal anlage tumor, a...
Pineal anlage tumor is a rare pediatric tumor with clinical and histological features overlapping with pineoblastoma. Two patients with pineal anlage tumor, a 13-month-old female and an 11-month-old male, underwent subtotal resection, high-dose chemotherapy with autologous stem cell rescue, and radiation. Neither had tumor progression 50 months after diagnosis. The tumors underwent next-generation sequencing on a panel of 340 genes. Chromosomal copy gains and losses were present and differed between the tumors. No mutations or amplifications, including none specific to pineoblastoma, were identified.
Topics: Brain Neoplasms; Child; Chromosome Aberrations; Female; Humans; Infant; Male; Mutation; Pineal Gland; Pinealoma; Supratentorial Neoplasms
PubMed: 35129878
DOI: 10.1002/pbc.29596 -
Pathology International Dec 1994An unusual tumor in the spinal cord of a 57 year old man is reported. At the age of 42 years, the patient had had a pineal region tumor that subsequently disappeared...
An unusual tumor in the spinal cord of a 57 year old man is reported. At the age of 42 years, the patient had had a pineal region tumor that subsequently disappeared completely after local radiation therapy only. Eleven and 15 years later, at the ages of 53 and 57 years, respectively, solitary spinal cord tumors were found and removed. Pathological examination revealed that these tumors were of neurogenic origin and showed the characteristic features of pineal parenchymal tumors such as pineocytoma and pineoblastoma. Based on the cytology of individual tumor cells and the absence of mitotic figures and necrotic foci, this patient was diagnosed as having metastatic pineocytoma of the spinal cord. This case suggests that distant, subarachnoidal metastasis to the spinal cord can occur in pineocytomas even after long-term dormancy.
Topics: Brain Neoplasms; Humans; Male; Middle Aged; Pineal Gland; Pinealoma; Spinal Cord Neoplasms
PubMed: 7866570
DOI: 10.1111/j.1440-1827.1994.tb01685.x -
Neuro-Chirurgie 2015Numerous tumour types can occur in the pineal region. Because these tumours are uncommon and heterogeneous, it is often difficult to establish optimal treatment... (Review)
Review
Numerous tumour types can occur in the pineal region. Because these tumours are uncommon and heterogeneous, it is often difficult to establish optimal treatment strategies based on comparative clinical trials. To date, the role of radiosurgery for the treatment of pineal region tumours remains controversial. This report of a 10-year single-department experience and review of the literature focuses on the spectrum of pathologic features found in these pineal parenchymal tumours and on the interest of radiosurgery in their management. Considering pineocytomas, although these tumours have been considered to be radioresistant to fractionated radiotherapy, our results are in agreement with similar results reported in the literature in suggesting that radiosurgery may be an alternative to surgical resection or an adjuvant therapy when the resection is not optimal. When dissemination occurs after radiosurgery, however, craniospinal radiation and chemotherapy are necessary. Radiosurgery has also proven its interest in the treatment of germinomas as an alternative to encephalic radiotherapy with limited long-term damage. Regarding the other pathologies, radiosurgery can be considered as part of a multimodal treatment including surgery, chemo-radiotherapy and its role still has to be clearly defined.
Topics: Brain Neoplasms; Humans; Pineal Gland; Pinealoma; Radiosurgery; Supratentorial Neoplasms; Treatment Outcome
PubMed: 24874722
DOI: 10.1016/j.neuchi.2013.11.007 -
Acta Neuropathologica May 1998Using both tumor specimen and cultured tumor cells, we have studied the differentiation of a pineocytoma by light and electron microscopy (EM) and immunohistochemical...
Using both tumor specimen and cultured tumor cells, we have studied the differentiation of a pineocytoma by light and electron microscopy (EM) and immunohistochemical demonstration of glial, neuronal and neuroendocrine markers. Only interstitial cells were labeled with anti-glial fibrillary acidic protein and anti-S100 protein antibodies. Synaptophysin, neurofilaments and tau labeling was found in cells forming the pineocytomatous rosettes. Some cells also bound the anti-tryptophan hydroxylase antibody (TPOH), but no staining was seen after application of anti-chromogranin A or S-antigen antibodies. EM provided evidence for neurosensory differentiation demonstrating the presence of vesicle-crowned rodlets, cilia (9+0) and fibrous filaments. In culture, tumor cells proliferated slowly and showed positive immunolabeling for vimentin and TPOH. Expression of mRNA coding for TPOH, serotonin N-acetyltransferase, hydroxyindole-O-methyl-transferase and c-myc was found in the tumor using reverse transcriptase-polymerase chain reaction. These results demonstrate neuronal differentiation of this pineocytoma and suggest that the neoplastic pineal cells are capable of synthesizing serotonin and melatonin.
Topics: Acetylserotonin O-Methyltransferase; Arylamine N-Acetyltransferase; Blotting, Western; Brain Neoplasms; Cells, Cultured; DNA Primers; Female; Fluorescent Antibody Technique, Direct; Humans; Immunohistochemistry; Microscopy, Electron; Middle Aged; Pinealoma; Polymerase Chain Reaction; RNA; Tryptophan Hydroxylase
PubMed: 9600600
DOI: 10.1007/s004010050834 -
Neurosurgery Clinics of North America Jul 2011Tumors of the pineal region can arise from multiple cellular origins and thus represent a very heterogeneous group of pathologies. Such tumors include pineal parenchymal... (Review)
Review
Tumors of the pineal region can arise from multiple cellular origins and thus represent a very heterogeneous group of pathologies. Such tumors include pineal parenchymal tumors, germ cell tumors, astrocytomas, ependymomas, and papillary pineal tumors. Within the subgroup of pineal parenchymal tumors, there is a histopathologic spectrum ranging from pineocytoma to pineal parenchymal tumors of intermediate differentiation to pineoblastoma. The current World Health Organization classification and the pathologic features of each of the pineal parenchymal tumor subtypes are reviewed in this article.
Topics: Diagnosis, Differential; Humans; Pineal Gland; Pinealoma
PubMed: 21801981
DOI: 10.1016/j.nec.2011.05.006 -
Progress in Neurological Surgery 2009The deep-seated location of pineal parenchymal tumors (PPTs) and their associations with critical structures make their surgical resection technically challenging;... (Review)
Review
The deep-seated location of pineal parenchymal tumors (PPTs) and their associations with critical structures make their surgical resection technically challenging; further, the rarity of PPTs and repeated changes in their histopathological diagnostic criteria makes the study of their biological behavior and clinical outcomes difficult. Here, we describe the surgical techniques and results of an occipital transtentorial approach for PPTs together with the results in the clinicopathological study of PPTs. Since 1982, we have treated 93 patients with pineal region tumors, including 17 PPTs, with the occipital transtentorial approach using the lateral semiprone position. The infrasplenial approach is helpful in separating the internal cerebral veins from the tumor, particularly when the tumor is tightly adherent to the veins. Permanent homonymous hemianopsia occurred in 1 of the 17 patients with PPTs. Permanent ocular movement disorders were not encountered. Extensive removal of the tumor significantly prolongs survival at least in patients with pineocytomas and PPT of intermediate differentiation (PPTIMD). Despite extensive resection and adjuvant radiochemotherapy, the prognosis of the patients with pineoblastomas is extremely poor. Although the proliferative potentials of pineocytomas and PPTIMD were significantly lower than those of pineoblastomas, there was no such difference between pineocytomas and PPTIMD.
Topics: Brain Neoplasms; Germinoma; Humans; Neurosurgical Procedures; Occipital Bone; Perioperative Care; Pineal Gland; Pinealoma
PubMed: 19329859
DOI: 10.1159/000210051 -
Brain Pathology (Zurich, Switzerland) Jan 2000The WHO classification of CNS tumors divides pineal parenchymal tumors (PPT) into pineocytoma (PC), pineoblastoma (PB) and mixed pineocytoma-pineoblastoma or PPT with... (Review)
Review
The WHO classification of CNS tumors divides pineal parenchymal tumors (PPT) into pineocytoma (PC), pineoblastoma (PB) and mixed pineocytoma-pineoblastoma or PPT with intermediate differentiation. The reported incidence of mixed/intermediate PPT varies and this may reflect the difficulty in classifying tumors of this type. In an attempt to overcome the problem of the classification of PPT with intermediate differentiation, we describe the relationship between histological features and patient survival in a large cooperative series of 66 PPT from 12 neurosurgical centres. All tumors were studied with both light microscopy and immunohistochemically using antibodies against glial markers or neural/neuroendocrine markers. Our series included 11 PC, 39 mixed/intermediate PPT and 16 PB. A number of mitoses greater than 6 and the presence of necrosis were associated with a poorer outcome, while positive immunostaining for neurofilaments was associated with a better survival. We propose a new prognostic grading of 4 grades, grade I for PC, grade II for PPT with fewer than 6 mitoses and positive immunolabelling for neurofilaments, grade III for PPT with either 6 or more than 6 mitoses or fewer than 6 mitoses but without immunostaining for neurofilaments and grade IV for PB.
Topics: Adolescent; Adult; Aged; Brain Neoplasms; Child; Child, Preschool; Female; Humans; Immunohistochemistry; Infant; Male; Middle Aged; Pineal Gland; Pinealoma; Prognosis
PubMed: 10668895
DOI: 10.1111/j.1750-3639.2000.tb00242.x -
Acta Pathologica Japonica Jul 1984An autopsy case of a 69-year-old female with pineocytoma was reported. The tumor showed neuronal differentiations, which were confirmed not only by light microscopy and...
An autopsy case of a 69-year-old female with pineocytoma was reported. The tumor showed neuronal differentiations, which were confirmed not only by light microscopy and electron microscopy, but also by a cell marker of neuron-specific enolase. In addition, existence of astrocytes in the tumor which distributed sparsely was ascertained by electron microscopy and cell markers such as S-100 protein and glial fibrillary acidic protein.
Topics: Aged; Brain Neoplasms; Female; Glial Fibrillary Acidic Protein; Humans; Nerve Tissue Proteins; Pinealoma
PubMed: 6485805
DOI: 10.1111/j.1440-1827.1984.tb07622.x -
Journal of Neurosurgery. Pediatrics Jun 2010Pineal tumors are rare neoplasms that are categorized into pineoblastomas, pineocytomas, and pineal parenchymal tumors of intermediate differentiation. Pineal anlage... (Review)
Review
Pineal tumors are rare neoplasms that are categorized into pineoblastomas, pineocytomas, and pineal parenchymal tumors of intermediate differentiation. Pineal anlage tumors are primary pineal tumors with neuroepithelial and ectomesenchymal differentiation and without endodermal differentiation. The authors review the literature and report the case of a 5-month-old boy with a pineal anlage tumor. This is only the sixth case of a pineal anlage tumor reported in the English-language literature adding to the understanding of this tumor's presentation, immunomorphological and molecular characteristics, embryological origin, radiological appearance, treatment outcome, and prognosis.
Topics: Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Biopsy; Chemotherapy, Adjuvant; Combined Modality Therapy; Craniotomy; Diagnosis, Differential; Emergencies; Humans; Hydrocephalus; Infant; Magnetic Resonance Imaging; Male; Neuroectodermal Tumor, Melanotic; Neuroendoscopy; Neurologic Examination; Pineal Gland; Pinealoma; Tomography, X-Ray Computed; Ventriculostomy
PubMed: 20515340
DOI: 10.3171/2010.2.PEDS09294