• World Neurosurg · Dec 2015

    Multicenter Study

    Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas.

    • Melissa A Gener, Andrew R Conger, Jamie Van Gompel, Mohammad S Ariai, Mark Jentoft, Fredric B Meyer, Jeremy S Cardinal, José M Bonnin, and Aaron A Cohen-Gadol.
    • Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
    • World Neurosurg. 2015 Dec 1; 84 (6): 1816-24.

    IntroductionPineoblastomas are uncommon primitive neuroectodermal tumors that occur mostly in children; they are exceedingly rare in adults. Few published reports have compared the various aspects of these tumors between adults and children.MethodsThe authors report a series of 12 pineoblastomas in adults from 2 institutions over 24 years. The clinical, radiologic, and pathologic features and clinical outcomes were compared with previously reported cases in children and adults.ResultsPatient age ranged from 24 to 81 years, and all but 1 patient exhibited symptoms of obstructive hydrocephalus. Three patients underwent gross total resection, and subtotal resection was performed in 3 patients. Diagnostic biopsy specimens were obtained in an additional 6 patients. Pathologically, the tumors had the classical morphologic and immunohistochemical features of pineoblastomas. Postoperatively, 10 patients received radiotherapy, and 5 patients received chemotherapy. Compared with previously reported cases, several differences were noted in clinical outcomes. Of the 12 patients, only 5 (42%) died of their disease (average length of survival, 118 months); 5 patients (42%) are alive with no evidence of disease (average length of follow-up, 92 months). One patient died of unrelated causes, and one was lost to follow-up. Patients with subtotal resections or diagnostic biopsies did not suffer a worse prognosis. Of the 9 patients with biopsy or subtotal resection, 4 are alive, 4 died of their disease, and 1 died of an unrelated hemorrhagic cerebral infarction.ConclusionsAlthough this series is small, the data suggest that pineoblastomas in adults have a less aggressive clinical course than in children.Copyright © 2015 Elsevier Inc. All rights reserved.

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