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Updated: Mar 31, 2026
Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
Published on: June 28, 2024
[Pineal region tumors in children: is gross-total resection necessary? A single-center experience]
Enrique López-Aguilar1, María del Carmen Garza-González, Mariana Ortiz-Azpilcueta
1Jefatura de Servicio de Oncología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. elopezaguilar@hotmail.com.
Insights
Biopsy followed by chemotherapy and radiotherapy offers better survival for children with pineal region tumors compared to gross resection. This approach reduces mortality and endocrine complications in pediatric patients.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Endocrinology
Background:
- Pineal region tumors in children are associated with significant endocrine disorders, morbidity, and mortality, particularly after aggressive surgical resection.
- Survival rates for pediatric pineal region tumors have improved, yet outcomes remain challenging.
Purpose of the Study:
- To analyze survival, outcomes, morbidity, and mortality in pediatric patients with pineal region tumors.
- To compare the effects of different surgical approaches (gross resection vs. biopsy) and treatments on patient outcomes.
Main Methods:
- Retrospective analysis of pediatric patients (≤17 years) diagnosed with pineal region tumors over a 10-year period.
- Inclusion of histopathological review and assessment of the extent of surgical resection.
- Estimation of patient survival rates.
Main Results:
- Out of 46 patients, 36 had complete data. Gross resection was performed in 66.6% and biopsy in 33.3%.
- Ten-year survival rates were 52% for gross resection and 75% for biopsy (p=0.7).
- Endocrine alterations occurred in 36.1% of patients, with 76.9% of these having undergone total resection.
Conclusions:
- Diagnostic biopsy followed by adjuvant chemotherapy and radiotherapy is a viable treatment strategy for pediatric pineal region tumors.
- Minimally invasive surgical approaches may be associated with better outcomes and reduced endocrine complications.
- Further research is needed to optimize treatment protocols for these rare pediatric tumors.
Background:
Survival of children with pineal region tumors has increased significantly in the last decade; these tumors have an insidious outcome associated with endocrine disorders with high morbidity and mortality, especially after gross resection. The objective was to report the survival, outcome, morbidity and mortality according to type of surgery, histology and treatment in children with pineal region tumors.
Methods:
This retrospective study included all patients of 17 years or less with diagnosis of pineal region tumor, who went over a period of 10 years to a children's hospital. A histopathological review was made, and the extent of resection was determined. The survival was also estimated.
Results:
Forty-six patients were included, out of which 36 had complete medical records and adequate pathologic material. Gross resection was performed in 24 (66.6 %), and biopsy in 12 (33.3 %); 23 (88 %) patients died; hydroelectrolytic imbalance was the cause of 14 deaths (60 %) and the other nine (39.1 %) were secondary to tumor progression. Ten-years survivals among patients treated with gross resection and biopsy were 52 and 75 %, respectively (p = 0.7). Endocrine alterations were observed in 13 patients (36.1 %); in 10 of these (76.9 %) the total resection was performed.
Conclusions:
Pineal region tumors in children can be treated with diagnostic biopsy, followed by adjuvant treatment consisting of chemotherapy and radiotherapy.
