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Pineal tumors: experience with 48 cases over 10 years
1Department of Neurosurgery, Seoul National University Children's Hospital, Korea.
Summary
Pineal region tumors are more common in males and children, with germ cell tumors (GCT) being the most frequent. Treatment approaches vary, impacting patient prognosis and survival rates.
Area of Science:
- Neuro-oncology
- Pediatric oncology
- Neurosurgery
Background:
- Pineal region tumors are rare and diverse, presenting diagnostic and therapeutic challenges.
- Understanding the epidemiology and outcomes of these tumors is crucial for optimizing patient care.
Purpose of the Study:
- To analyze the clinical characteristics, treatment modalities, and outcomes of patients with pineal region tumors.
- To evaluate the efficacy and safety of surgical and adjuvant therapies for various pineal region tumor types.
Main Methods:
- Retrospective review of 48 patients treated at Seoul National University Hospital (SNUH) from 1986 to 1995.
- Classification of tumors including germ cell tumors (GCT), pineoblastoma (PB), pineocytoma (PC), and others.
- Analysis of presenting symptoms, surgical approaches (occipital transtentorial approach - OTT), radiotherapy (RT), and radiochemotherapy.
Main Results:
- Germ cell tumors (GCT) constituted 69% of cases, with a male and childhood predominance.
- Increased intracranial pressure and Parinaud syndrome were common presenting symptoms.
- Overall 3-year survival rate was 84%, with favorable outcomes for germinoma and teratoma, but poorer outcomes for nongerminomatous malignant GCT and pineoblastoma.
Conclusions:
- Pineal region tumors exhibit a male and childhood predilection, with GCT being the most prevalent type.
- The occipital transtentorial approach is a safe and effective surgical option.
- Prognosis is significantly influenced by tumor pathology and treatment modality, highlighting the need for tailored therapeutic strategies.