OBJECTIVE: Pineal parenchymal tumors (PPTs) in adults are rare, and knowledge regarding their optimal management and treatment outcome is limited. Herein, we present the clinical results of our series of PPTs other than pineoblastomas managed by stereotactic radiosurgery (SRS) at upfront setting. METHODS: Between 1997 and 2014, nine consecutive adult patients with the diagnosis of PPTs, either pineocytoma or pineal parenchymal tumor of intermediate differentiation, were treated with SRS. There were 6 men and 3 women. The median age was 39 years (range, 31-53 years). All of the patients presented with symptoms of hydrocephalus. Endoscopic third ventriculostomy and biopsy was done for initial management. After histologic diagnosis, patients were treated with Gamma Knife with the mean dose of 13.3 Gy (n=3) or fractionated Cyberknife with 32 Gy (n=6). RESULTS: After a mean follow-up of 78.6 months (range, 14-223 months), all patients were alive and all of their tumors were locally controlled except for one instance of cerebrospinal fluid seeding metastasis. On magnetic resonance images, tumor size decreased in all patients, resulting in complete response in 3 patients and partial response in 6. One patient had experienced temporary memory impairment after SRS, which improved spontaneously. CONCLUSION: SRS is effective and safe for PPTs in adults and can be considered as a useful alternative to surgical resection at upfront setting.
OBJECTIVE:Pineal parenchymal tumors (PPTs) in adults are rare, and knowledge regarding their optimal management and treatment outcome is limited. Herein, we present the clinical results of our series of PPTs other than pineoblastomas managed by stereotactic radiosurgery (SRS) at upfront setting. METHODS: Between 1997 and 2014, nine consecutive adult patients with the diagnosis of PPTs, either pineocytoma or pineal parenchymal tumor of intermediate differentiation, were treated with SRS. There were 6 men and 3 women. The median age was 39 years (range, 31-53 years). All of the patients presented with symptoms of hydrocephalus. Endoscopic third ventriculostomy and biopsy was done for initial management. After histologic diagnosis, patients were treated with Gamma Knife with the mean dose of 13.3 Gy (n=3) or fractionated Cyberknife with 32 Gy (n=6). RESULTS: After a mean follow-up of 78.6 months (range, 14-223 months), all patients were alive and all of their tumors were locally controlled except for one instance of cerebrospinal fluid seeding metastasis. On magnetic resonance images, tumor size decreased in all patients, resulting in complete response in 3 patients and partial response in 6. One patient had experienced temporary memory impairment after SRS, which improved spontaneously. CONCLUSION:SRS is effective and safe for PPTs in adults and can be considered as a useful alternative to surgical resection at upfront setting.
Authors: Toshinori Hasegawa; Douglas Kondziolka; Constantinos G Hadjipanayis; John C Flickinger; L Dade Lunsford Journal: Neurosurgery Date: 2002-10 Impact factor: 4.654
Authors: Juha Hernesniemi; Rossana Romani; Baki S Albayrak; Hanna Lehto; Reza Dashti; Christian Ramsey; Ayse Karatas; Andrea Cardia; Ondrej Navratil; Anna Piippo; Minoru Fujiki; Stefano Toninelli; Mika Niemelä Journal: Surg Neurol Date: 2008-12
Authors: Johannes Lutterbach; François Fauchon; Steven E Schild; Susan M Chang; Axel Pagenstecher; Benedikt Volk; Christoph Ostertag; Felix Momm; Anne Jouvet Journal: Neurosurgery Date: 2002-07 Impact factor: 4.654
Authors: Gregory P Lekovic; L Fernando Gonzalez; Andrew G Shetter; Randall W Porter; Kris A Smith; David Brachman; Robert F Spetzler Journal: Neurosurg Focus Date: 2007 Impact factor: 4.047