The pineal region is defined as the area bounded dorsally by the splenium of the corpus callosum and the tela choroidea, ventrally by the quadrigeminal plate and midbrain tectum, rostrally by the posterior aspect of third ventricle, and caudally by the cerebellar vermis. Pineocytoma is a slow-growing pineal parenchimal tumor in young adults and composed of cells resembling pineocytes. It represents 0.4-1% of primary brain tumors. Pineocytomas account for 45% of pineal region neoplasm. Age: peak incidence 10-20 years. There are 3 types of pineal parenchimal tumors: pineocytoma (well differentiated tumor); pineal parenchimal tumor with intermediate differentiation; pineoblastoma (malignant tumor).
MR findings: T1WI - isointense to hypointense round or lobular mass; T2WI - hyperintense round or lobular pineal mass; T1 C+ - homogeneous enhancement.
Presentation: headache; Parinaud syndrome; ataxia; hydrocephalus. Surgical procedures are limited to ~ 25% of tumors.
Postoperative complications include: cerebellar ataxia, infection, epidural fluid collection. Overall 5 year survival 86%. Mortality rate: 5 - 10%.
MR findings: T1WI - isointense to hypointense round or lobular mass; T2WI - hyperintense round or lobular pineal mass; T1 C+ - homogeneous enhancement.
Presentation: headache; Parinaud syndrome; ataxia; hydrocephalus. Surgical procedures are limited to ~ 25% of tumors.
Postoperative complications include: cerebellar ataxia, infection, epidural fluid collection. Overall 5 year survival 86%. Mortality rate: 5 - 10%.
References
- Handbook of Neurosurgery - fifth edition - Mark S. Greenberg - ed. Thieme.
- Diagnostic Imaging - Brain - Osborn - First edition;second printing- Amirsys - Elsevier Saunders - 2004.
