Pinealoma. A report of twelve irradiated cases

The records of 12 patients with a diagnosis of pinealoma or ectopic pinealoma irradiated at Montefiore Hospital and Medical Center between 1961 and 1971 were reviewed. Diagnosis was made clinically and radiographically. Histology is available in three cases. Eight cases were treated with small fields (4 X 4 to 6 X 8 cm), two cases with intermediate, and two with whole brain fields. Doses between 5000 and 6000 rads were given by Cobalt-60 or 33 MeV x-rays. Eight patients (66%) showed no evidence of active disease from 4 to 14 years after irradiation. Of eight patients treated with small fields, seven are free of disease (88%). Of the remainder, 50% are free of disease. One patient subsequently developed cerebrospinal spread. The challenge to the radiotherapist is to identify the more aggressive or extensive lesion with the ultimate aim of achieving cure with the most limited treatment.