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Pineoblastoma in adults

S M Chang1, P K Lillis-Hearne, D A Larson

  • 1Department of Neurological Surgery, University of California, School of Medicine, San Francisco, USA.

Neurosurgery
|September 1, 1995
PubMed
Summary
This summary is machine-generated.

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Staging pineoblastoma at diagnosis is crucial for prognosis. Patients with widespread disease at diagnosis had poorer outcomes than those with localized tumors.

Area of Science:

  • Neuro-oncology
  • Pediatric and Adult Brain Tumors
  • Clinical Neuroscience

Background:

  • Pineoblastomas are rare, aggressive primitive neuroectodermal tumors primarily affecting children, but also occurring in adults.
  • Accurate staging is essential for determining prognosis and guiding treatment strategies in neuro-oncology.
  • Previous staging protocols for pineoblastomas have varied, particularly in adult populations.

Purpose of the Study:

  • To report the outcomes of adult patients with pineoblastoma staged across the entire neuraxis at diagnosis.
  • To evaluate the prognostic significance of disease extent at diagnosis for pineoblastoma.
  • To recommend optimal initial staging procedures for pineoblastoma.

Main Methods:

  • Retrospective review of 11 adult patients (age > 16) with histologically confirmed pineoblastomas diagnosed between 1975 and 1992.

Related Experiment Videos

  • Neuraxis staging included cerebrospinal fluid examination and spinal magnetic resonance imaging.
  • Surgical resection extent and follow-up data were analyzed to correlate with patient outcomes.
  • Main Results:

    • All 11 patients presented with symptomatic hydrocephalus.
    • Five patients with positively staged disease (metastases) experienced progression and died within 1-20 months post-recurrence (median overall survival 30 months).
    • In contrast, five patients with negatively staged disease (no metastases) remained alive without progression after a median follow-up of 26 months.

    Conclusions:

    • The extent of pineoblastoma at diagnosis is a significant prognostic factor, similar to medulloblastomas and other primitive neuroectodermal tumors.
    • Comprehensive initial staging, including cerebrospinal fluid analysis and spinal MRI, is critical for adult pineoblastoma patients.
    • The benefit of adjuvant systemic chemotherapy following craniospinal irradiation for pineoblastomas remains uncertain.