• Junpeng Ji, Chunyu Gu, Mingshan Zhang, Hongwei Zhang, Haoran Wang, Yanming Qu, Ming Ren, Weihai Ning, and Chunjiang Yu.
• Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
• Medicine (Baltimore). 2019 Aug 1; 98 (34): e16652e16652.

IntroductionTumors of the pineal region are rare, and metastatic carcinoma occurring in the pineal region is extremely rare. No previous reports have described pineal region metastasis with intraventricular seeding.Patient ConcernsWe report a case of a 51-year-old woman presented with a 1-week history of severe headache, nausea, and vomiting. Imaging examination revealed 2 lesions in the pineal region and the right lateral ventricle.DiagnosisPinealocytoma or germinoma was considered as the preoperative diagnosis. The postoperative pathological diagnosis was small cell neuroendocrine carcinoma. After bronchoscopic biopsy, small cell lung cancer was confirmed.InterventionsA right frontal craniotomy and a translateral ventricle approach were performed to remove 2 lesions completely. And regular radiotherapy and chemotherapy were initiated after surgery.OutcomesThe patient was discharged from the hospital 2 weeks after operation and went to another cancer hospital for bronchoscopic biopsy, radiotherapy, and chemotherapy. Finally, the patient died 2 years after surgical treatment.ConclusionMetastatic tumors of the pineal region are very rare. For patients with pineal lesions, a diagnosis of a metastatic tumor should be considered. Retrograde cerebrospinal fluid circulation might be the reason for a secondary metastasis.

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