Tumours in the pineal and supra-sellar region. A review of clinical manifestations and managements.

The records of 14 patients with a tumour in the pineal or supra-sellar region seen at The Norwegian Radium Hospital, Oslo between 1973-1980 have been studied retrospectively. The problems with a widely accepted classification are discussed, as well as the choice of treatment (surgery versus radiation) and the indications for local or total CNS radiation. All patients should start radiation treatment to a local field with a generous margin. After 20 Gy a CT scan should be performed. A marked reduction in tumour size indicate a radiosensitive tumour (germ cell tumour or pineoblastoma) and the radiation field should be extended to total CNS who receives 30 Gy. No change on CT scan after 20 Gy indicate a tumour of glial origin or pineocytoma, the radiation should then continue with a local field to 50 Gy.