Francesco Cuccia1, Gianluca Mortellaro2, Daniela Cespuglio3, Vito Valenti1, Giorgia DE Gregorio1, Emanuele Quartuccio1, Livio Blasi4, Natale Francaviglia5, Cristina Gallo6, Antonio Lo Casto7, Giuseppe Ferrera2. 1. Radiation Oncology School, University of Palermo, Palermo, Italy. 2. Radiation Oncology, ARNAS Civico Hospital, Palermo, Italy. 3. Radiation Oncology, ARNAS Civico Hospital, Palermo, Italy danielacespuglio@virgilio.it. 4. Oncology Unit, ARNAS Civico Hospital, Palermo, Italy. 5. Division of Neurosurgery, ARNAS Civico Hospital, Palermo, Italy. 6. Radiology Unit, ARNAS Civico Hospital, Palermo, Italy. 7. Radiation Oncology School, Section of Radiological Sciences, DIBIMED, University of Palermo, Palermo, Italy.
Abstract
BACKGROUND/AIM: Pineoblastoma of the adult age is an uncommon tumor with only 200 cases reported. A standardized approach for an optimal adjuvant strategy is currently lacking. The case presented herein also deals with the issue of central nervous system tumors in pregnancy. CASE REPORT: A 21-year-old pregnant woman presented with massive hydrocephalus due to a mass in the pineal region detected with MRI. After positioning an urgent ventricular derivation, a cesarean section was performed. During a third ventriculocisternostomy, a biopsy revealed a pineoblastoma. After a maximal safe resection, postoperative craniospinal irradiation for a total dose of 36 Gy plus a sequential boost to the tumor bed to 54 Gy, and adjuvant chemotherapy with CDDP plus CCNU plus vincristine were performed. After one year, the patient is alive with no evidence of disease. CONCLUSION: The use of adjuvant radio-chemotherapy provided excellent outcomes in our case. The advanced gestational age facilitated the choice of the therapeutic strategy. Copyright
BACKGROUND/AIM: Pineoblastoma of the adult age is an uncommon tumor with only 200 cases reported. A standardized approach for an optimal adjuvant strategy is currently lacking. The case presented herein also deals with the issue of central nervous system tumors in pregnancy. CASE REPORT: A 21-year-old pregnant woman presented with massive hydrocephalus due to a mass in the pineal region detected with MRI. After positioning an urgent ventricular derivation, a cesarean section was performed. During a third ventriculocisternostomy, a biopsy revealed a pineoblastoma. After a maximal safe resection, postoperative craniospinal irradiation for a total dose of 36 Gy plus a sequential boost to the tumor bed to 54 Gy, and adjuvant chemotherapy with CDDP plus CCNU plus vincristine were performed. After one year, the patient is alive with no evidence of disease. CONCLUSION: The use of adjuvant radio-chemotherapy provided excellent outcomes in our case. The advanced gestational age facilitated the choice of the therapeutic strategy. Copyright