Abstract
Although several series of pineal region tumors are available, the issue of pineal gliomas has been scarcely faced in the literature. Gliomas are usually included in largest series of pineal neoplasms. Therefore, whether pineal gliomas share the biological behavior of either hemispheric gliomas or other midline lesions is not yet defined. The aim of this retrospective study is to analyze long-term morbidity and mortality of these lesions. In English published literature gliomas account for about 14–22 % of all pineal region tumors. Most of these tumors are pilocytic astrocytomas, while glioblastoma multiforme is rare. We retrospectively analyzed all pineal region tumors operated on in our department in the last 28 years, and identified eight pineal astrocytomas, accounting for 14.03 % of all pineal tumors. The series includes four pilocytic astrocytomas, two grade II diffuse astrocytomas, and two anaplastic astrocytomas. A comprehensive review of the available literature data shows that the mean survival time of WHO grade II gliomas is shorter when tumor grows in the pineal region than for hemispheric locations, although the limited amount of available data prevents a rigorous statistical analysis. This difference might be due to the peculiar infiltrating behavior of pineal tumors, which often can’t be satisfactorily resected from vital structures.
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References
Blakeley JO, Grossman SA (2006) Management of pineal region tumors. Curr Treat Options Oncol 7(6):505–516
Thakar S, Sai Kiran NA, Ghosal N, Hegde AS (2012) Pleomorphic xanthoastrocytoma: a new differential diagnosis for a pediatric pineal neoplasm. Brain Tumor Pathol 29(3):168–171
Morgenstern PF, Osbun N, Schwartz TH, Greenfield JP, Tsiouris AJ, Souweidane MM (2011) Pineal region tumors: an optimal approach for simultaneous endoscopic third ventriculostomy and biopsy. Neurosurg Focus 30(4):E3
Wong TT, Chen HH, Liang ML, Yen YS, Chang FC (2011) Neuroendoscopy in the management of pineal tumors. Childs Nerv Syst 27(6):949–959
Jia W, Ma Z, Liu IY, Zhang Y, Jia G, Wan W (2011) Transcallosal interforniceal approach to pineal region tumors in 150 children. J Neurosurg Pediatr 7(1):98–103
Levidou G, Korkolopoulou P, Agrogiannis G, Paidakakos N, Bouramas D, Patsouris E (2010) Low-grade oligodendroglioma of the pineal gland: a case report and review of the literature. Diagn Pathol 5:59
Nagaishi M, Yokoo H, Hirato J, Yoshimoto Y, Nakazato Y (2011) Clinico-pathological feature of pilomyxoid astrocytomas: three case reports. Neuropathology 31(2):152–157
Srinivas BH, Uppin MS, Panigrahi MK, Vijaya Saradhi M, Jyotsna Rani Y, Challa S (2010) Pleomorphic xanthoastrocytoma of the pineal region. J Clin Neurosci 17(11):1439–1441
Ohta T, Yachi K, Ogino A, Yokoyama T, Fukushima T, Watanabe T, Yoshino A, Katayama Y, Honma T, Sugitani M (2010) Pleomorphic granular cell astrocytoma in the pineal gland: case report. Neuropathology 30(6):615–620
Sajko T, Kudelić N, Lupret V, Lupret V Jr, Nola IA (2009) Treatment of pineal region lesions: our experience in 39 patients. Coll Antropol 33(4):1259–1263
Yazici N, Varan A, Söylemezoğlu F, Zorlu F, Kutluk T, Akyüz C, Büyükpamukçu M (2009) Pineal region tumors in children: a single center experience. Neuropediatrics 40(1):15–21
Al-Hussaini M, Sultan I, Abuirmileh N, Jaradat I, Qaddoumi I (2009) Pineal gland tumors: experience from the SEER database. J Neurooncol 94(3):351–358
Arantes M, Vaz AR, Honavar M, Resende M, Pereira JR (2009) Pilocytic astrocytoma arising from the pineal gland. J Neuroradiol 36(3):177–178
Leston J, Mottolese C, Champier J, Jouvet A, Brun J, Sindou M, Chazot G, Claustrat B, Fèvre-Montange M (2009) Contribution of the daily melatonin profile to diagnosis of tumors of the pineal region. J Neurooncol 93(3):387–394
Kim TW, Lee TK, Kim BS, Lee KS, Song IU, Kim JS (2009) Diurnally fluctuating frontal dysequilibrium secondary to a pineal pilocytic astrocytoma: is this symptom associated with a check-valve mechanism in a pineal region tumor? Childs Nerv Syst 25(3):367–371
Al-Tamimi YZ, Bhargava D, Surash S, Ramirez RE, Novegno F, Crimmins DW, Tyagi AK, Chumas PD (2008) Endoscopic biopsy during third ventriculostomy in paediatric pineal region tumours. Childs Nerv Syst 24(11):1323–1326
Lekovic GP, Gonzalez LF, Shetter AG, Porter RW, Smith KA, Brachman D, Spetzler RF (2007) Role of gamma knife surgery in the management of pineal region tumors. Neurosurg Focus 23(6):E12
Catrambone JE, He W, Prestigiacomo CJ, Carmel PW (2007) Monitoring papilledema in a patient with pineal pilocytic astrocytoma by using Heidelberg Retina Tomograph II. Case report. J Neurosurg 107(2 Suppl):163–166
Tirakotai W, Riegel T, Stiegel A, Hellwig D, Heinze S, Bertalanffy H, Celik I (2007) Peri-operative quality of life assessment in endoscopically treated patients with pineal region tumours. Childs Nerv Syst 23(6):659–663
Das S, Chandler JP, Pollack A, Biggio EH, Diaz L, Raizer JJ, Batjer HH (2006) Oligodendroglioma of the pineal region. Case report. J Neurosurg 105(3):461–464
Chernov MF, Kamikawa S, Yamane F, Ishihara S, Kubo O, Hori T (2006) Neurofiberscopic biopsy of tumors of the pineal region and posterior third ventricle: indications, technique, complications, and results. Neurosurgery 59(2):267–277
Amini A, Schmidt RH, Salzman KL, Chin SS, Couldwell WT (2006) Glioblastoma multiforme of the pineal region. J Neurooncol 79(3):307–314
Reis F, Faria AV, Zanardi VA, Menezes JR, Cendes F, Queiroz LS (2006) Neuroimaging in pineal tumors. J Neuroimaging 16(1):52–58
Kumar P, Tatke M, Sharma A, Singh D (2006) Histological analysis of lesions of the pineal region: a retrospective study of 12 years. Pathol Res Pract 202(2):85–92
Toyooka T, Miyazawa T, Fukui S, Otani N, Nawashiro H, Shima K (2005) Central neurogenic hyperventilation in a conscious man with CSF dissemination from a pineal glioblastoma. J Clin Neurosci 12(7):834–837
Dashti SR, Robinson S, Rodgers M, Cohen AR (2005) Pineal region giant cell astrocytoma associated with tuberous sclerosis: case report. J Neurosurg 102(3 Suppl):322–325
Ogura T, Adachi J, Nishikawa R, Hirose T, Matsutani M (2004) Synchronous optic and pineal pilocytic astrocytomas in a paediatric patient with neurofibromatosis type 1. Pediatr Neurosurg 40(6):301–305
Amendola BE, Wolf A, Coy SR, Amendola MA, Eber D (2005) Pineal tumors: analysis of treatment results in 20 patients. J Neurosurg 102 Suppl:175–179
Parwani AV, Baisden BL, Erozan YS, Burger PC, Ali SZ (2005) Pineal gland lesions: a cytopathologic study of 20 specimens. Cancer 105(2):80–86
Yamini B, Refai D, Rubin CM, Frim DM (2004) Initial endoscopic management of pineal region tumors and associated hydrocephalus: clinical series and literature review. J Neurosurg 100(5 Suppl Pediatrics):437–441
Yurtseven T, Erşahin Y, Demirtaş E, Mutluer S (2003) Neuroendoscopic biopsy for intraventricular tumors. Minim Invasive Neurosurg 46(5):293–299
Gasparetto EL, Warszawiak D, Adam GP, Bleggi-Torres LF, de Carvalho Neto A (2003) Glioblastoma multiforme of the pineal region: case report. Arq Neuropsiquiatr 61(2B):468–472
Knierim DS, Yamada S (2003) Pineal tumors and associated lesions: the effect of ethnicity on tumor type and treatment. Pediatr Neurosurg 38(6):307–323
Konovalov AN, Pitskhelauri DI (2003) Principles of treatment of the pineal region tumors. Surg Neurol 59(4):250–268
Saran FH, Baumert BG, Khoo VS, Adams EJ, Garré ML, Warrington AP, Brada M (2002) Stereotactically guided conformal radiotherapy for progressive low-grade gliomas of childhood. Int J Radiat Oncol Biol Phys 53(1):43–51
Nitta J, Tada T, Kyoshima K, Goto T, Ishii K, Hongo K, Kobayashi S (2001) Atypical pleomorphic astrocytoma in the pineal gland: case report. Neurosurgery 49(6):1458–1460 discussion 1460-1
Nomura K (2001) Epidemiology of germ cell tumors in Asia of pineal region tumor. J Neurooncol 54(3):211–217
Pople IK, Athanasiou TC, Sandeman DR, Coakham HB (2001) The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours. Br J Neurosurg 15(4):305–311
Rivarola MA, Belgorosky A, Mendilaharzu H, Vidal G (2001) Precocious puberty in children with tumours of the suprasellar and pineal areas: organic central precocious puberty. Acta Paediatr 90(7):751–756
Oi S, Shibata M, Tominaga J, Honda Y, Shinoda M, Takei F, Tsugane R, Matsuzawa K, Sato O (2000) Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study. J Neurosurg 93(2):245–253
Engel U, Gottschalk S, Niehaus L, Lehmann R, May C, Vogel S, Jänisch W (2000) Cystic lesions of the pineal region—MRI and pathology. Neuroradiology 42(6):399–402
Grimoldi N, Tomei G, Stankov B, Lucini V, Masini B, Caputo V, Repetti ML, Lazzarini G, Gaini SM, Lucarini C, Fraschini F, Villani R (1998) Neuroendocrine, immunohistochemical, and ultrastructural study of pineal region tumors. J Pineal Res 25(3):147–158
Cho BK, Wang KC, Nam DH, Kim DG, Jung HW, Kim HJ, Han DH, Choi KS (1998) Pineal tumors: experience with 48 cases over 10 years. Childs Nerv Syst 14(1–2):53–58
Oi S, Matsuzawa K, Choi JU, Kim DS, Kang JK, Cho BK (1998) Identical characteristics of the patient populations with pineal region tumors in Japan and in Korea and therapeutic modalities. Childs Nerv Syst 14(1–2):36–40
Gaab MR, Schroeder HW (1998) Neuroendoscopic approach to intraventricular lesions. J Neurosurg 88(3):496–505
Regis J, Bouillot P, Rouby-Volot F, Figarella-Branger D, Dufour H, Peragut JC (1996) Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases. Neurosurgery 39(5):907–912 discussion 912-4
Prahlow JA, Challa VR (1996) Neoplasms of the pineal region. South Med J 89(11):1081–1087
Park SH, Park HR, Chi JG (1996) Papillary ependymoma: its differential diagnosis from choroid plexus papilloma. J Korean Med Sci 11(5):415–421
Kreth FW, Schätz CR, Pagenstecher A, Faist M, Volk B, Ostertag CB (1996) Stereotactic management of lesions of the pineal region. Neurosurgery 39(2):280–289 discussion 289-91
Matsumoto K, Higashi H, Tomita S, Ohmoto T (1995) Pineal region tumours treated with interstitial brachytherapy with low activity sources (192-iridium). Acta Neurochir (Wien) 136(1–2):21–28
Yoshida J, Wakabayashi T, Mizuno M, Sugita K, Seo H, Oshima M, Tadokoro M, Sakuma S (1992) Tumor-specific binding of radiolabeled G-22 monoclonal antibody in glioma patients. Neurol Med Chir (Tokyo) 32(3):125–129
Satoh H, Uozumi T, Kiya K, Kurisu K, Arita K, Sumida M, Ikawa F (1995) MRI of pineal region tumours: relationship between tumours and adjacent structures. Neuroradiology 37(8):624–630
Bruce JN, Stein BM (1995) Surgical management of pineal region tumors. Acta Neurochir (Wien) 134(3–4):130–135
Valentini L, Bogni A, Bombardieri E, Broggi G, Pluchino F (1991) Placental alkaline phosphatase in the cerebrospinal fluid of patients affected by pineal region neoplasms. Int J Biol Markers 6(3):195–196
Linggood RM, Chapman PH (1992) Pineal tumors. J Neurooncol 12(1):85–91
Chao CK, Lee ST, Lin FJ, Tang SG, Leung WM (1993) A multivariate analysis of prognostic factors in management of pineal tumor. Int J Radiat Oncol Biol Phys 27(5):1185–1191
Popovic EA, Kelly PJ (1993) Stereotactic procedures for lesions of the pineal region. Mayo Clin Proc 68(10):965–970
Barnett DW, Olson JJ, Thomas WG, Hunter SB (1995) Low-grade astrocytomas arising from the pineal gland. Surg Neurol 43(1):70–75 discussion 75-6
Ganz JC, Smievoll AI, Thorsen F (1994) Radiosurgical treatment of gliomas of the diencephalon. Acta Neurochir Suppl 62:62–66
Hoffman HJ, Soloniuk DS, Humphreys RP, Drake JM, Becker LE, De Lima BO, Piatt JH Jr (1993) Management and outcome of low-grade astrocytomas of the midline in children: a retrospective review. Neurosurgery 33(6):964–971
Pople IK, Arango JC, Scaravilli F (1993) Intrinsic malignant glioma of the pineal gland. Childs Nerv Syst 9(7):422–424
Mineura K, Sasajima T, Kowada M, Saitoh H, Shishido F (1993) Case report: radiation-induced vasculopathy implicated by depressed blood flow and metabolism in a pineal glioma. Br J Radiol 66(788):727–733
Snipes GJ, Horoupian DS, Shuer LM, Silverberg GD (1992) Pleomorphic granular cell astrocytoma of the pineal gland. Cancer 70(8):2159–2165
Nazzaro JM, Shults WT, Neuwelt EA (1992) Neuro-ophthalmological function of patients with pineal region tumors approached transtentorially in the semisitting position. J Neurosurg 76(5):746–751
Yoshida J, Wakabayashi T, Mizuno M, Sugita K, Seo H, Oshima M, Tadokoro M, Sakuma S (1992) Tumor-specific binding of radiolabeled G-22 monoclonal antibody in glioma patients. Neurol Med Chir (Tokyo) 32(3):125–129
Oi S, Matsumoto S (1992) Controversy pertaining to therapeutic modalities for tumors of the pineal region: a worldwide survey of different patient populations. Childs Nerv Syst 8(6):332–336
Dempsey PK, Kondziolka D, Lunsford LD (1992) Stereotactic diagnosis and treatment of pineal region tumours and vascular malformations. Acta Neurochir (Wien) 116(1):14–22
Vaquero J, Ramiro J, Martínez R, Bravo G (1992) Neurosurgical experience with tumours of the pineal region at Clinica Puerta de Hierro. Acta Neurochir (Wien) 116(1):23–32
Taratuto AL, Sevlever G, Piccardo P (1991) Clues and pitfalls in stereotactic biopsy of the central nervous system. Arch Pathol Lab Med 115(6):596–602
Yamashita J, Handa H (1988) Diagnosis and treatment of pineal tumours. Kyoto University experience (1941–1984). Acta Neurochir Suppl (Wien) 42:137–141
Zee CS, Segall H, Apuzzo M, Destian S, Colletti P, Ahmadi J, Clark C (1991) MR imaging of pineal region neoplasms. J Comput Assist Tomogr 15(1):56–63
Lapras C, Patet JD, Mottolese C, Lapras C Jr (1987) Direct surgery for pineal tumors: occipital-transtentorial approach. Prog Exp Tumor Res 30:268–280
Schulte FJ, Herrmann HD, Müller D, Franke H, Saeger W, Spaar FW, Bartels S (1987) Pineal region tumours of childhood. Eur J Pediatr 146(3):233–245
Vaquero J, Ramiro J, Martinez R (1990) Glioblastoma multiforme of the pineal region. J Neurosurg Sci 34(2):149–150
Pluchino F, Broggi G, Fornari M, Franzini A, Solero CL, Allegranza A (1989) Surgical approach to pineal tumours. Acta Neurochir (Wien) 96(1–2):26–31
Clarke JC (1988) Computed tomography of pineal region ependymoma. Br J Radiol 61(730):953–955
Edwards MS, Hudgins RJ, Wilson CB, Levin VA, Wara WM (1988) Pineal region tumors in children. J Neurosurg 68(5):689–697
Hoffman HJ (1987) Pineal region tumors. Prog Exp Tumor Res 30:281–288
Bruce DA, Allen JC (1985) Tumor staging for pineal region tumors of childhood. Cancer 56(7 Suppl):1792–1794
Levin CV, Rutherfoord GS (1985) Pineal tumours at Groote Schuur Hospital, 1976–1984. S Afr Med J 68(1):33–35
Ganti SR, Hilal SK, Stein BM, Silver AJ, Mawad M, Sane P (1986) CT of pineal region tumors. Am J Roentgenol 146(3):451–458
Benjamin JC, Furneaux CE, Scholtz CL (1985) Pineal astrocytoma. Surg Neurol 23(2):139–142
Frank F, Gaist G, Piazza G, Ricci RF, Sturiale C, Galassi E (1985) Stereotaxic biopsy and radioactive implantation for interstitial therapy of tumors of the pineal region. Surg Neurol 23(3):275–280
Neuwelt EA, Buchan C, Blank NK, Lewy AJ (1985) Surgical resection of a pineal tumor containing elements of germinoma and astrocytoma. Neurosurgery 16(3):373–378
Boyd MC, Steinbok P (1985) Pineal region tumors. Can J Neurol Sci 12(1):35–38
The commitee of brain tumor registry in Japan (1992) Brain tumor registry of Japan. Neurol Med Chir (Tokyo) 32:381–547
Grazionao SL, Paolozzi FP, Rudolph AR, Stewart WA, Elbadawi A, Comis RL (1987) Mixed germ-cell tumor of the pineal region. J Neurosurg 66:300–304
Herrick MK, Rubinstein LJ (1979) The cytological differentiating potential of pineal parenchymal neoplasms (true pinealomas). A clinicopathological study of 28 tumors. Brain 102:289–320
Koide O, Watanabe Y, Sato K (1980) A pathological survey of intracranial germinoma and pinealoma in Japan. Cancer 45:2119–2130
Rubinstein LJ (1981) Cytogenesis and differentiation of pineal neoplasms. Hum Pathol 12:441–448
Hirato J, Nakazato Y (2001) Pathology of pineal region tumors. J Neurooncol 54:239–249
Schwartzbaum JA, Fisher JL, Aldape KD, Wrensch M (2006) Epidemiology and molecular pathology of glioma. Nat Clin Pract Neurol 2(9):494–503
Ohgaki H, Kleihues P (2005) Epidemiology and etiology of gliomas. Acta Neuropathol 109(1):93–108
Oertel J, von Buttlar E, Schroeder HW, Gaab MR (2005) Prognosis of gliomass in the 1970s and today. Neurosurg Focus 18(4):e12
Nunez OM, Seol HJ, Rutka JT (2009) The role of surgery in the management of intracranial gliomass: current concepts. Indian J Cancer 46(2):120–126
Durmaz R, Vural M, Işildi E, Coşan E, Ozkara E, Bal C, Ciftçi E, Arslantaş A, Atasoy MA (2008) Efficacy of prognostic factors on serviva in patients with low grade gliomas. Turk Neurosurg 18(4):336–344
Moon K-S, Jung S, Jung T-Y, Kim I-Y, Lee M-C, Lee K-H (2008) Primary glioblastoma in the pineal region: a case report and review of the literature. J Med Case Rep 2:288
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Salima Magrini and Alberto Feletti contributed equally to this study
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Magrini, S., Feletti, A., Marton, E. et al. Gliomas of the pineal region. J Neurooncol 115, 103–111 (2013). https://doi.org/10.1007/s11060-013-1200-9
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DOI: https://doi.org/10.1007/s11060-013-1200-9