Diagnosis and treatment of tumours in the pineal region.

In a series of 3.072 cases of intracranial neoplasms up to the end of 1973 there were 82 tumours in the pineal region (2.7%), excluding meningiomas of the falx and tentorium. More than half (forty seven) were pinealomas (two cell pattern type tumours, and pineoblastomas), twelve were teratomas, eight were ependymomas, three were epidermoids, and the remainder were gliomas. In addition to ventriculography, millipore filter-cell culture of cerebrospinal fluid, and fibre ventriculoscopy were found useful for diagnosis. Most of the patients were treated by surgery followed by radiotherapy. Results with the pinealomas were fairly good, the one year, five year, and ten year survival rates being 87.5%, 71.4%, and 33.3% in those below the age of 15 years, and 80.0%, 46.2%, and 12.5% in those above that age. The radiosensitivity of pinealomas and the beneficial effect of reduction of tumour bulk by direct surgery may both be important factors in the achievement of good results.