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Pineal and third ventricle tumours in the CT and MR eras
M Fukui1, T Matsushima, K Fujii
1Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
Abstract:
We have experienced 29 cases of tumour in the pineal region and posterior third ventricle in the CT and MR eras (from 1976 to 1989). An aggressive surgical removal was performed except for germinomas and suspected germinomas. The aggressive surgical cases were 5 teratomas including one inclusion foetus, one yolk sac tumour, 3 astrocytomas, one neurocytoma, one cavernous haemangioma and one telangiectasia. The surgery was performed by either the infratentorial supracerebellar approach or the occipital transtentorial approach. There was no surgical death and the quality of postoperative survival was good in patients with benign tumours. The cases of a typical teratoma, teratoma with an arterio-venous shunt, inclusion foetus, haemorrhagic nodule of telangiectasia etc. are briefly presented. A remarkable progress in the diagnosis and surgical treatment of tumours in the pineal region in the CT and MR eras is noted in our results.
Insights
This study reviewed 29 pineal region tumors treated between 1976-1989. Aggressive surgical removal yielded good outcomes for benign tumors, demonstrating progress in diagnosis and treatment.
Area of Science:
- Neurosurgery
- Neuroradiology
- Oncology
Background:
- Tumors in the pineal region and posterior third ventricle pose significant diagnostic and therapeutic challenges.
- Advances in Computed Tomography (CT) and Magnetic Resonance (MR) imaging have revolutionized the understanding and management of these lesions.
Observation:
- A series of 29 cases of pineal region and posterior third ventricle tumors were analyzed from the CT and MR imaging eras (1976-1989).
- Surgical intervention was primarily aggressive, excluding germinomas and suspected germinomas.
- Surgical approaches included the infratentorial supracerebellar and occipital transtentorial routes.
Findings:
- Aggressively treated tumors included teratomas (n=5), astrocytomas (n=3), neurocytoma (n=1), cavernous hemangioma (n=1), and telangiectasia (n=1).
- No surgical mortality was observed.
- Patients with benign tumors experienced a good quality of postoperative survival.
Implications:
- The study highlights significant advancements in the diagnostic accuracy and surgical treatment strategies for pineal region tumors.
- Effective surgical management, particularly for benign lesions, leads to favorable long-term outcomes.
- Continued integration of advanced imaging techniques is crucial for optimizing patient care in neuro-oncology.