A case of ectopic pinealoma in the region of the sellar trucica, which not enlarged reaiologically, so-called the intrasellar germinoma is described with its clinical manifestions, roentgenographic pictures, pathological findings and therapeutic points of view.
Germinoma ; Pinealoma

A case of ectopic pinealoma in the region of the sellar trucica, which not enlarged reaiologically, so-called the intrasellar germinoma is described with its clinical manifestions, roentgenographic pictures, pathological findings and therapeutic points of view.
Germinoma ; Pinealoma

The management of pineal region tumor remains controversial. This paper reports a case of pineocytoma which was attempted to improve treatment planning by the use of clinical features, computerized tomography, and markers for germ-cell tumor. A presumptive diagnosis could be made and this tumor less likely to respond to radiotherapy was subjected to primary surgery.
Diagnosis ; Pinealoma* ; Radiotherapy

The diagnosis and treatment of pineal tumor has captivated the interest of neurosurgeons for decades. Reports indicated that the majority of these tumors were malignant and thereby couild not be surgically removed and decompressed without high mortality and morbidity. And the pineal tumor especially germinoma is one of the mosdt radiosensitive intracranial tumors. Therefore a regime of radiotherapy combined with ventricular shunting, to relieve hydrocephalus, was advocated. In addition, with development of C-T we make the diagnosis easily and assess the result of treatment. We report a pineal tumor which was treated completely by irradiation following ventriculo-atrial shunt.
Diagnosis ; Germinoma ; Hydrocephalus ; Mortality ; Pinealoma* ; Radiotherapy

Stereotaxic biopsy is an useful technique as an alternative to craniotomy for the tissue diagnosis of the intracranial tumors, especially such as deep seated tumor or malignant neoplasm in the dominant hemisphere. Such biopsy was more safe and lesser expensive than any other procedures and had high accuracy. For the purpose of more accuracy, the authors inserted small steel ball marker at the biopsy site and performed repeat C-T brain scanning immediately after the operation. We could confirm the marker in the tumor tissue on the C-T scans. The authors had experienced 4 cases of stereotaxic biopsy as follow; 2 cases of thalamic astrocytomas, 1 case of pineocytoma and 1 case of astrocytoma grade II in the dominant hemisphere. Neither mortality nor morbidity was noted.
Astrocytoma ; Biopsy* ; Brain Neoplasms* ; Brain* ; Craniotomy ; Diagnosis ; Mortality ; Pinealoma ; Steel

We herein present a rare case of pineocytoma in a 23-year-old female exhibiting distinct histomorphological features. The tumor contained highly pleomorphic, often multinucleated giant cells in the background of otherwise benign pineocytomatous architecture, which at first led to an erroneous diagnosis of a high grade malignancy. However, the worrisome histological findings turned out to be constituents of a distinct subtype of pineocytoma previously described as pleomorphic variant of pineocytoma. Although it is rare, pathologists should be aware of this entity since the tumor takes on a benign clinical course like any other classic pineocytomas.
Diagnosis ; Female ; Giant Cells ; Humans ; Pineal Gland ; Pinealoma* ; Young Adult

20 cases of midline pineal tumors and 3 suprasellar germinomas received radiation therapy at Yonsei University Medical College, Severance hospital from 1971 to 1982 were reviewed. 12 cases were pathologically proved; 10 germinomas, 1 pineoblastoma, and 1 pineocytoma. 11 cases received radiotherapy without biopsy confirmation. Although treatment fields varied from small field to whole brain irradiation, but not to the spinal cord, most patients received 4000-000 rads irradiation to the primary tumor site. 17 patients are alive without evidence of disease and 5 year actuarial NED survival is 73.2%. 9 of 10 biopsy proved germinomas and all 6 presumed germinomas are alive and well. Optimum radiation dose, adequate irradiation field, tumor response to radiation observed in serial CT scan and role of radiation therapy in the management of pineal tumors are also discussed.
Biopsy ; Brain ; Germinoma* ; Humans ; Pinealoma* ; Radiotherapy ; Spinal Cord ; Tomography, X-Ray Computed

A 64-year-old man was admitted to our hospital in semicomatous consciousness. Brain computed tomography scans demonstrated 2.6 x 2.5 cm sized hyperdense mass in the pineal region with multiple punctate calcifications and hydrocephalus. Brain magnetic resonance imaging demonstrated a pineal mass which was heterogeneously enhanced with gadolinium. After external ventricular drainage, the patient regained consciousness. The mass was totally removed via occipital transtentorial approach. No consequent ventricular shunt was needed and the patient recovered without any neurological deficit. Final pathologic report of the tumor was ependymoma.
Brain ; Consciousness ; Drainage ; Ependymoma* ; Gadolinium ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Middle Aged ; Pinealoma

From December 1984 to February 1990, 16 patients with tumors of pineal and suprasellar location were treated with radiation therapy. Tissue diagnoses were obtained before radiation therapy in 5 patients and 11 were irradiated without histologic confirmation. Initial treatments for these patients were craniospinal plus boost primary irradiation(six), whole brain plus boost primary irradiation(nine), primary tumor site irradiation(one). The 5 year actuarial survival rate is 71%. Three cases with elevated beta-human chorionic gonadotropin (HCG) responded favorably to radiation, but pineal tumors with elevated alpha-fetoprotein(AFP) did not respond well. Spinal metastasis developed in 2 cases (2/15) with elevated AFP : one received prophylactic spinal irradiation, another did not. Our studies suggest that more aggressive treatment would be necessary in patient with elevated AFP and in this patient, radiation therapy may be initiate without pathologic confirmation. From the result of our study, routine use of prophylactic spinal irrdiation for all patients with pineal region tumor is not indicated and use of prophylactic spinal irrdiation is considered for the patients with positive craniospinal fluid cytology, meningeal seeding, disease extension along the ventricular wall and biopsy proven germinoma
Biopsy ; Brain ; Chorionic Gonadotropin ; Diagnosis ; Germinoma ; Humans ; Neoplasm Metastasis ; Pinealoma* ; Radiotherapy* ; Survival Rate ; Biomarkers, Tumor

With advances in MR imaging, reports of pineal cyst have become more common. In contrast to pineal neoplasm, a pineal cyst is usually asymptomatic and is detected incidentally. We reviewed six cases of pineal cyst diagnosed between 1991 and 1996. Only one patient presented with syncopal attack due to compression of the midbrain. MRI typically reveals a cystic mass with a mean diameter of 1.66cm and shows faint rim-like contrast enhancement. Since it shows the anatomic relationship of the cyst to the aquedect, sagittal MRI is the most useful diagnost test. In the one symptomatic patient, we performed suboccipital cramiectomy and removed the cyst. It contained clear fluid and was easily removed. Surgery can be considered only when the lesion produces symptoms due to compression of the quadrigeminal plate, aqueduct, or midbrain. The long term behavior of these lesions is, however, unknown, so only with follow-up for long time will appropriate management techniques become apparent.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Pineal Gland* ; Pinealoma ; Tectum Mesencephali