Surgical Approaches to Pineal Region Tumors

Area of Science:

• Neurosurgery
• Neuro-oncology

Background:

• Pineal region tumors present unique surgical challenges due to their location.
• Historically, these tumors had high morbidity and mortality rates.

Purpose of the Study:

• To review anatomical, diagnostic, and surgical principles for managing pineal region lesions.
• To guide approach selection based on institutional experience and outcomes.

Main Methods:

• Review of anatomical considerations for surgical approaches.
• Description of key operative corridors: endoscopic third ventriculostomy with biopsy, supracerebellar infratentorial, occipital transtentorial, posterior interhemispheric transsplenial, anterior transchoroidal, and combined supra-/infratentorial.
• Presentation of institutional experience and outcome data.

Main Results:

• Advances in neuroimaging, microsurgery, and endoscopy have transformed pineal region tumor management.
• Improved outcomes compared to historical data.

Conclusions:

• Optimal management requires an individualized, anatomy-driven strategy.
• Integration of tumor pathology, patient presentation, and surgeon expertise is crucial for selecting the best surgical corridor.