[A case of pineocytoma presenting with symptoms like normal pressure hydrocephalus]

A pineocytoma in an old man, whose initial symptoms resembled a normal pressure hydrocephalus, is reported. This 67-year-old man gradually became uncommunicative and difficult to walk alone in three months. Just before visiting our clinic, his family also noticed his nocturnal urinary incontinence. CT scan on admission disclosed tumor in the posterior wall of the third ventricle, and subsequent hydrocephalus. This oval, isodense tumor was homogeneously enhanced after the injection of contrast medium on CT scan. The vertebral angiography showed a mass in the pineal region with no vascular staining. Ventricular drainage, the opening pressure of which was 100 mmH2O, could not offer cytological verification of the tumor. By the infratentorial supracerebellar approach, the tumor was successfully extirpated, and the post-operative course was uneventful. The microscopic study revealed the nature of this tumor to be well compatible with that of a pineocytoma.