-transparent.png){kind=logo}
BACKGROUND Pineal parenchymal tumors are rare; therefore, only limited clinical data regarding their behavior is available. This study was performed to provide further information regarding the pathologic features, clinical behavior, and response to therapy of these tumors. METHODS This study includes data concerning 30 patients (15 male and 15 female patients) with pineal parenchymal tumors (PPT) diagnosed between 1939 and 1991. Based on gross and microscopic features, tumors were divided into four groups: pineocytomas (9); PPT with intermediate differentiation (4); mixed PPT exhibiting elements of both pineocytoma and pineoblastoma (2); and pineoblastomas (15). At the time of diagnosis, four patients had evidence of spinal seeding (two with pineoblastoma, two with PPT with intermediate differentiation). Twenty-two patients received radiation therapy (RT): 6 were treated to local fields, 7 to the whole brain, and 9 to the craniospinal axis. RESULTS For patients who received RT and had a minimum follow-up of 6 months, local failure occurred in one of four patients with pineocytomas, zero of four patients with PPT with intermediate differentiation, one of two with mixed PPT, and four of nine (44%) with pineoblastomas. In patients receiving > or = 50 Gy to the primary tumor, 0 of 12 had local failure compared with 6 of 7 (86%) patients receiving lesser doses. Leptomeningeal failure occurred in zero of four patients with pineocytomas, zero of four patients with PPT with intermediate differentiation, one of two with mixed PPT, and four of nine with pineoblastomas. All leptomeningeal failures occurred in patients with persistent primary tumor. Of the patients with seeding tumors (PPT other than pineocytomas) one of seven (14%) developed leptomeningeal failure when treated with craniospinal irradiation, compared with four of eight (50%) treated to lesser volumes. The projected 1-year, 3-year, and 5-year survival rates of patients with pineocytomas were 100%, 100%, and 67%, and were 88%, 78%, and 58% for those with the other forms of PPT, respectively. CONCLUSIONS RT recommendations are described in detail and include the use of doses of > or = 50 Gy to areas of gross disease and the administration of craniospinal irradiation in patients with tumors prone to seeding. Surgical, chemotherapeutic, and pathologic considerations are discussed.
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
April 2010,
Neurosurgical review,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
October 2023,
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
July 2011,
Neurosurgery clinics of North America,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
January 2009,
Progress in neurological surgery,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
January 2012,
Handbook of clinical neurology,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
January 1974,
Transactions of the American Neurological Association,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
January 1994,
Journal of cancer research and clinical oncology,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
January 1995,
Journal of computer assisted tomography,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
November 1995,
Journal of child neurology,
S E Schild, and
B W Scheithauer, and
P J Schomberg, and
C C Hook, and
P J Kelly, and
L Frick, and
J S Robinow, and
S J Buskirk
May 2021,
Acta neuropathologica,
