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Pineal region tumors: computed tomographic-pathologic spectrum

N N Futrell, A G Osborn, B D Cheson

    AJR. American Journal of Roentgenology
    |November 1, 1981
    PubMed
    Summary
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    Computed tomographic (CT) scans reveal significant diversity in pineal tumors, challenging previous assumptions of a definitive appearance. Biopsy is recommended for accurate diagnosis and treatment planning of these heterogeneous lesions.

    Area of Science:

    • Neuroradiology
    • Oncology
    • Pathology

    Background:

    • Pineal tumors are uncommon neoplasms of the posterior third ventricle.
    • Previous computed tomographic (CT) studies have suggested a pathognomonic appearance for some pineal tumors.
    • Limited research has focused on the heterogeneity of these lesions.

    Purpose of the Study:

    • To illustrate the histopathologic and CT appearance heterogeneity of pineal region tumors.
    • To evaluate the diagnostic utility of CT in characterizing diverse pineal lesions.
    • To emphasize the importance of biopsy for treatment planning.

    Main Methods:

    • Retrospective analysis of nine biopsy-proved pineal gland tumors.
    • Inclusion of eight other presumed pineal region tumors.

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  • Detailed review of histopathologic findings and CT characteristics (margination, attenuation, calcification, suprasellar extension).

    • Main Results:

    • Demonstrated remarkable heterogeneity in both histopathologic and CT appearance across various tumor types (germinomas, teratocarcinomas, hamartomas, etc.).
    • Observed variable CT features including margination, attenuation, calcification, and suprasellar extension.
    • Identified germinomas as having the best response to radiation therapy.

    Conclusions:

    • Pineal region tumors exhibit significant heterogeneity, contradicting the notion of a virtually pathognomonic CT appearance.
    • Biopsy of pineal region tumors is feasible and crucial for accurate diagnosis and effective treatment planning.
    • Understanding this heterogeneity is vital for appropriate management strategies, especially considering treatment responses like that of germinomas to radiation therapy.