Pineal tumors describes a number of different tumors. The particular type of brain tumor is related to the type of cell from which the tumor originates, and, in the pineal region, there are number of possibilities. Pineal region tumors account for about 1% of all primary brain tumors in adults and around 9% of brain tumors in children. Some of the types of tumors seen in the pineal region are pineocytoma, pineoblastoma, astrocytoma, oligodendroglioma, meningioma, pineal cyst (a form of arachnoid cyst), germinoma and teratoma.
SYMPTOMS
The most common group of symptoms associated with pineal region tumors are those relating to increased pressure in the head. These include headache, nausea and vomiting. Because of their location, Pineal tumors can cause Parinaud’s syndrome. This is an inability to look up.
DIAGNOSIS
As always, the first steps in diagnosis are a careful history and physical examination. A CT scan or better, an MRI scan performed without and with intravenous contrast enhancement is the next step. In some cases, tumor markers can be found in the spinal fluid. Unfortunately, it is frequently too dangerous to perform a spinal tap in patients with these tumors.
TREATMENT
The treatment of tumors in the pineal region depends on the particular tumor, the size and the medical condition of the patient. Stereotactic biopsy can be quite dangerous in this location. Open approaches to these tumors are probably more useful for both biopsy and tumor removal. Further treatment with radiation therapy or stereotactic radiosurgery is not unusual. A number of tumors in this region can metastasize in the spinal fluid and in some cases outside of the nervous system.