Pineal Gland Parenchyma Tumors.

Area of Science:

• Neuro-oncology
• Central Nervous System Neoplasms
• Tumor Histopathology

Background:

• Pineal parenchymal tumors (PPTs) are rare central nervous system neoplasms with diverse histological subtypes and WHO grades (1-4).
• Understanding their epidemiology, clinical presentation, and molecular features is crucial for effective management.

Purpose of the Study:

• To provide a comprehensive review of pineal parenchymal tumors (PPTs).
• To emphasize surgical approaches and prognostic factors in PPT management.
• To incorporate updated WHO 2021 classifications and newly recognized tumor types.

Main Methods:

• Extensive literature review incorporating updated WHO 2021 classifications.
• Analysis of data from large multicenter cohorts.
• Focus on histopathological and molecular features, surgical techniques, and prognostic indicators.

Main Results:

• PPTs exhibit variable presentation by age and subtype; pineocytomas (adults) have good outcomes post-resection, while pineoblastomas (pediatric) are aggressive with poor prognosis.
• Intermediate and papillary tumors show variable behavior, benefiting from maximal resection and adjuvant therapy.
• Surgical approaches include infratentorial supracerebellar and endoscopic techniques; Endoscopic third ventriculostomy (ETV) effectively manages hydrocephalus.

Conclusions:

• Individualized, multidisciplinary management is essential for PPTs.
• Gross total resection is the primary surgical goal; adjuvant therapy is guided by tumor type and grade.
• Future research should focus on molecular characterization, refining minimally invasive techniques, and multicenter studies for evidence-based protocols.