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Items 1 to 27 of about 27
1. Beck H, Moriyama E: Transverse sinus-tentorium splitting approach for pineal region tumors--case report. Neurol Med Chir (Tokyo); 2001 Apr;41(4):217-21
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  • [Title] Transverse sinus-tentorium splitting approach for pineal region tumors--case report.
  • A 15-year-old boy with a large pineal region mass was admitted to our institute.
  • The tentative diagnosis was mixed germ cell tumor.
  • Tumor resection was carried out via a transverse sinus-tentorium splitting approach.
  • The tumor tissue was completely resected, and no operative complication other than transient vertical gaze paresis was noted.
  • The histological diagnosis was mixed germ cell tumor composed of mature and immature teratoma, germinoma, and embryonal carcinoma.
  • After three courses of chemotherapy, the patient underwent external irradiation.
  • This approach enables safer and more extensive tumor removal for large pineal region tumors.
  • [MeSH-major] Brain Neoplasms / surgery. Neoplasms, Germ Cell and Embryonal / surgery. Neurosurgical Procedures / methods. Pineal Gland / pathology. Pineal Gland / surgery
  • [MeSH-minor] Adolescent. Brain / pathology. Brain / surgery. Humans. Male. Treatment Outcome

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  • (PMID = 11381683.001).
  • [ISSN] 0470-8105
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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2. Tsugu H, Oshiro S, Ueno Y, Abe H, Komatsu F, Sakamoto S, Matsumoto S, Nabeshima K, Fukushima T, Inoue T: Primary yolk sac tumor within the lateral ventricle. Neurol Med Chir (Tokyo); 2009 Nov;49(11):528-31
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  • [Title] Primary yolk sac tumor within the lateral ventricle.
  • A 13-year-old girl presented with an exceedingly rare case of primary yolk sac tumor located within the lateral ventricle, manifesting as headache, nausea, and diplopia.
  • The tumor was removed subtotally via left middle temporal corticotomy.
  • The histological and immunohistochemical diagnosis was pure yolk sac tumor.
  • The patient underwent radiotherapy (whole brain, 30 Gy; tumor bed, 21 Gy; whole spinal axis, 30 Gy) and chemotherapy (ifosfamide, cisplatin, etoposide).
  • After three treatment cycles, the serum AFP level had decreased to 4.5 ng/ml.
  • However, the tumor recurred with cerebrospinal fluid dissemination after nine cycles of chemotherapy.
  • The possibility of germ cell tumor should be considered in pediatric patients with brain tumors occurring outside the pineal or suprasellar region.
  • [MeSH-major] Brain / pathology. Cerebral Ventricle Neoplasms / diagnosis. Endodermal Sinus Tumor / diagnosis. Lateral Ventricles / pathology
  • [MeSH-minor] Adolescent. Biomarkers, Tumor / analysis. Biomarkers, Tumor / blood. Chorionic Gonadotropin, beta Subunit, Human / blood. Diplopia / etiology. Drug Therapy. Fatal Outcome. Female. Headache / etiology. Humans. Hydrocephalus / etiology. Intracranial Hypertension / etiology. Magnetic Resonance Imaging. Nausea / etiology. Neoplasm Metastasis. Neoplasm Recurrence, Local. Neurosurgical Procedures. Radiotherapy. Ventriculostomy. alpha-Fetoproteins / metabolism

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  • (PMID = 19940403.001).
  • [ISSN] 1349-8029
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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3. Amendola BE, Wolf A, Coy SR, Amendola MA, Eber D: Pineal tumors: analysis of treatment results in 20 patients. J Neurosurg; 2005 Jan;102(s_supplement):175-179

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pineal tumors: analysis of treatment results in 20 patients.
  • OBJECT: The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with tumors in the pineal region.
  • METHODS: This is a retrospective clinical evaluation of 20 patients with primary tumors of the pineal region treated with GKS from November 1994 through August 2003.
  • There were 13 germ cell tumors, two pineoblastomas, two low-grade gliomas, one primitive neuroectodermal tumor, one teratoma, and one pineocytoma.
  • The median margin dose was 11 Gy (range 8-20 Gy).
  • Five patients received sequential systemic chemotherapy and four underwent adjuvant conventional radiation therapy.
  • Three patients died: one of unrelated causes, one who presented with extensive local disease, and the other of meningeal carcinomatosis with local control of the primary tumor.
  • CONCLUSIONS: This initial experience suggests that GKS is a valuable treatment modality for the management of pineal region tumors.
  • This technique offers excellent local tumor control and minimal patient morbidity, allowing for immediate use of systemic chemotherapy and/or conventional radiation if indicated.

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  • (PMID = 28306462.001).
  • [ISSN] 1933-0693
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Keywords] NOTNLM ; gamma knife surgery / glioma / pineal tumor / pineoblastoma / pineocytoma / primitive neuroectodermal tumor / teratoma
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4. Kanamori M, Kumabe T, Tominaga T: Is histological diagnosis necessary to start treatment for germ cell tumours in the pineal region? J Clin Neurosci; 2008 Sep;15(9):978-87
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  • [Title] Is histological diagnosis necessary to start treatment for germ cell tumours in the pineal region?
  • The significance of histological diagnosis was retrospectively investigated in the treatment of 79 consecutive patients with pineal region tumours.
  • Histological diagnoses were consistent with clinical diagnoses in 38 out of 39 patients with germ cell tumours and in all eight patients with non-germ cell tumours.
  • Forty-one patients were treated under a clinical diagnosis of pineal germ cell tumour using neoadjuvant chemotherapy and radiation therapy without histological verification.
  • Of the 41 patients, 32 achieved an excellent response, whereas nine required the delayed resection of a residual tumour.
  • These patients had elevated levels of tumour markers.
  • Most cases of pineal germ cell tumour could be identified on the basis of clinical findings only, and could be treated appropriately using neoadjuvant chemotherapy and radiation therapy without histological diagnosis.
  • [MeSH-major] Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy. Pineal Gland / pathology. Pinealoma / diagnosis. Pinealoma / therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antineoplastic Protocols / standards. Biomarkers, Tumor / analysis. Child. Child, Preschool. Decision Support Techniques. Female. Humans. Infant. Male. Middle Aged. Neurosurgical Procedures. Predictive Value of Tests. Radiotherapy / methods. Retrospective Studies. Teratoma / diagnosis. Teratoma / metabolism. Teratoma / therapy. Treatment Outcome

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  • (PMID = 18617412.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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5. Rejlekova K, Mego M, Rajec J, Sycova-Mila Z, Obertova J, Mardiak J: A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour. Bratisl Lek Listy; 2009;110(5):296-7
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  • [Title] A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour.
  • Though germ cell cancer is rare, it is the most common cancer in males between 20 and 40 years.
  • The primary site for the development of germ cell tumor is testes, but it can be seen in extragonadal locations as well.
  • Herein, we present a rare case of a 19-year-old patient with non/seminomatous extragonadal germ cell tumor in the pineal region with an aggressive behaviour, refractory to the combined therapy (surgery, radio- and chemotherapy).
  • We suggest that early diagnosis and aggressive multimodal approaches along with surgery, radiotherapy and chemotherapy is necessary to improve the outcome of these patients (Ref. 5).
  • [MeSH-major] Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Pineal Gland

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  • (PMID = 19507665.001).
  • [ISSN] 0006-9248
  • [Journal-full-title] Bratislavské lekárske listy
  • [ISO-abbreviation] Bratisl Lek Listy
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Slovakia
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6. Nomura K: Epidemiology of germ cell tumors in Asia of pineal region tumor. J Neurooncol; 2001 Sep;54(3):211-7
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  • [Title] Epidemiology of germ cell tumors in Asia of pineal region tumor.
  • A higher incidence of pineal region tumors in Asian countries compared to Western countries has been reported.
  • In the Brain Tumor Registry of Japan (BTRJ), there were 38,273 primary brain tumors except those of unknown histology (1123 cases) registered in the period between 1984 and 1993, in which 807 pineal region tumors with 104 unknown histology were registered in BTRJ.
  • Of these pineal region tumors, germ cell tumors had the highest frequency, 70.3%, followed by pineal parenchymal tumors, 12.0%; pineocytoma in 7.8% and pineoblastoma in 4.2%.
  • Limited to germ cell tumors, germinoma was 68.0%, then teratoma including malignant teratoma, had the second high frequency, 14.7% in pineal region.
  • While data reported by Allaire et al. and Edwards et al. revealed that the incidence of germinoma was 88.6%, 52.4% of germ cell tumors in pineal region in France and in USA, respectively.
  • Although number of cases is very small, it is suggested that the percentage of germinoma in germ cell tumors in the pineal region might be almost the same in Western countries as in Asian countries, and the occurrence of germ cell tumors in the pineal region was much higher than those in Asia.
  • Age and gender distribution of pineal region tumors indicated that germ cell tumors and pineocytoma showed a high incidence in males and in children.
  • Most of malignant pineal region tumors other than germinomas showed poor prognosis, but recent progress in surgical techniques and effective chemotherapy will improve the prognosis.
  • [MeSH-major] Brain Neoplasms / epidemiology. Germinoma / epidemiology. Pineal Gland

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  • (PMID = 11767288.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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7. Vervenne WL, Bakker PJ, Stalpers LJ, Bosch DA: [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation]. Ned Tijdschr Geneeskd; 2000 Mar 11;144(11):527-31
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  • [Title] [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation].
  • [Transliterated title] Maligne intracerebrale kiemceltumor behandeld met chemotherapie en radiotherapie zonder histopathologische diagnose.
  • In two men aged 19 and 24 years, a rare malignant intracranial germ cell tumour was diagnosed in the pineal gland region and in the second patient in a suprasellar position as well.
  • The clinical picture of a young patient with an intracerebral tumour localised in the midline of the brain and increased levels of the tumour markers alpha-foetoprotein and/or human chorion gonadotrophin (beta-HCG) in blood and/or CSF makes any other diagnosis highly unlikely.
  • There is no place for radical surgery in the first-line treatment of malignant intracerebral germ cell tumours because of the sensitivity to radio- and chemotherapy.
  • Also, the sensitivity to chemotherapy makes it possible to reduce radiation volume and dose in an effort to avoid the serious complications of craniospinal irradiation.
  • Both patients responded well to chemotherapy based on cisplatin followed by radiotherapy.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Chorionic Gonadotropin, beta Subunit, Human / blood. Chorionic Gonadotropin, beta Subunit, Human / cerebrospinal fluid. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Radiotherapy, Adjuvant. Tomography, X-Ray Computed. Treatment Outcome. alpha-Fetoproteins / cerebrospinal fluid

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  • (PMID = 10735140.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] NETHERLANDS
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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8. Cuccia V, Alderete D: Suprasellar/pineal bifocal germ cell tumors. Childs Nerv Syst; 2010 Aug;26(8):1043-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Suprasellar/pineal bifocal germ cell tumors.
  • PURPOSE: Intracranial germ cell tumors (GCT) arise from embryonal rests of germinal cells.
  • The aim of this report is to analyze a small group of GCT located simultaneously in the suprasellar and pineal regions without seeding either between both tumors or to other places.
  • We named this group as suprasellar/pineal bifocal germ cell tumors (SPBT).
  • METHODS: A retrospective review of a series of 25 GCT showed a) 16 cases of unifocal non-disseminated pineal or sellar GCT, b) one case of unifocal disseminated pineal GCT, c) three cases with suprasellar and pineal double tumors with dissemination, and d) five cases with SPBT.
  • Endocrine, ocular, and increased intracranial pressure syndromes were identified and related to the size of the tumors.
  • Chemotherapy and radiotherapy were performed in all SPBT.
  • Prognosis for bifocal groups was similar to unifocal tumors of the same histological type.
  • CONCLUSIONS: SPBT seem to be an entity defined by a) one tumor in the suprasellar and another in the pineal region, b) GCT with predominance of PG, but not exclusively, and c) MRI and endoscopy without any dissemination.
  • [MeSH-major] Brain Neoplasms / pathology. Neoplasms, Germ Cell and Embryonal / pathology. Pineal Gland / pathology. Pinealoma / pathology
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Child. Combined Modality Therapy. Female. Humans. Male. Neurosurgical Procedures. Radiotherapy. Retrospective Studies. Treatment Outcome

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  • (PMID = 20221609.001).
  • [ISSN] 1433-0350
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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9. Shim KW, Kim DS, Choi JU: Mixed or metachronous germ-cell tumor? Childs Nerv Syst; 2007 Jun;23(6):713-8
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  • [Title] Mixed or metachronous germ-cell tumor?
  • OBJECTIVE AND IMPORTANCE: We report the extremely rare occurrence of a second germ-cell tumor at a different site and with different histological types long after total resolution of a pineal germinoma.
  • Neuroradiological studies revealed a tumor in the pineal region.
  • The tumor was biopsied with endoscope, and third ventriculostomy was performed.
  • Histologically, the tumor proved to be a germinoma.
  • The patient received 3 cycles of combination chemotherapy consisting of carboplatin and etoposide with radiotherapy.
  • The tumor was totally resolute.
  • Neuroradiological studies showed a tumor in the right temporal lobe.
  • INTERVENTION: The second tumor was totally removed.
  • Histologically, the tumor proved to be a mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma.
  • After the second course of chemotherapy, magnetic resonance image studies revealed no evidence of the tumor.
  • CONCLUSION: The second tumor was considered to be a metachronous neoplasm rather than a recurrence of the original mixed germ-cell tumor, which consisted a yolk-sac tumor and a germinoma.
  • [MeSH-major] Brain Neoplasms / pathology. Endodermal Sinus Tumor / pathology. Germinoma / pathology. Neoplasms, Multiple Primary / pathology. Pinealoma / pathology. Temporal Lobe / pathology

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  • (PMID = 17187270.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
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10. Blakeley JO, Grossman SA: Management of pineal region tumors. Curr Treat Options Oncol; 2006 Nov;7(6):505-16
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of pineal region tumors.
  • Tumors of the pineal region represent a diverse collection of tumors with a variety of natural histories.
  • This diversity necessitates accurate histologic diagnosis to allow rational therapeutic planning.
  • Evaluation of a pineal lesion should begin with craniospinal MRI and analysis of the cerebrospinal fluid (CSF).
  • Whereas certainty of the histologic diagnosis is now a requirement for treatment in Western nations, some Asian centers continue to recommend a test dose of radiation therapy based on the high incidence of germinoma in those countries.
  • This approach provides adequate tissue for diagnosis, may be curative in low-grade tumors, and may substantially improve survival in patients with malignant tumors.
  • Radiation therapy is the first-line therapy for germinomas.
  • Although the optimal radiation dosage and volume have not been decided, the current Children's Oncology Group trial may offer definitive evidence to address this dilemma in germ cell tumors.
  • Evidence of CSF seeding requires craniospinal radiation and adjuvant chemotherapy regardless of tumor type.
  • Diagnosis of any of the malignant tumors (non-germ cell tumors, pineoblastomas, and parenchymal tumors of intermediate determination) also requires craniospinal radiation (with local tumor doses of at least 50 Gy) and adjuvant chemotherapy (generally platinum based).
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Pineal Gland
  • [MeSH-minor] Combined Modality Therapy. Glioma / diagnosis. Glioma / pathology. Glioma / therapy. Humans. Magnetic Resonance Imaging. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / therapy. Pinealoma / diagnosis. Pinealoma / pathology. Pinealoma / therapy

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  • (PMID = 17032562.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 59
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11. Kumabe T, Kusaka Y, Jokura H, Ikeda H, Shirane R, Yoshimoto T: [Recurrence of intracranial germinoma initially treated with chemotherapy only]. No Shinkei Geka; 2002 Sep;30(9):935-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Recurrence of intracranial germinoma initially treated with chemotherapy only].
  • Eight consecutive patients with intracranial germinoma underwent combination chemotherapy with BEP (bleomycin, etoposide, and cisplatin) or PE (cisplatin and etoposide) without irradiation between 1996 and 1997.
  • The diagnosis was based on endoscopic or stereotactic biopsy, or transsphenoidal surgery in 7 cases.
  • These 7 patients obtained complete response (CR) after treatment with chemotherapy only.
  • The diagnosis of pure germinoma was based on neuroradiographic appearances and the normal levels of tumor markers in patients with suprasellar and pineal-region germ cell tumors.
  • Although all patients obtained CR, 5 patients relapsed at a mean period of 19 months after the initial therapy.
  • Additional chemotherapy and total ventricle irradiation (24 Gy) achieved CR, but delayed seeding in the optic nerves outside the irradiated field was detected.
  • Another patient obtained CR after PE therapy, but there was not histological verification.
  • However, 35 months after the initial therapy, surgical extirpation of the recurrent tumor revealed immature teratoma.
  • One patient refused treatment for recurrence at the initial tumor site and died 42 months after the initial treatment.
  • Adequate initial therapy is absolutely essential for the treatment of intracranial germinoma.
  • The chemotherapy regimens in use today cannot be recommended as initial therapy without irradiation because of the high recurrence rates.
  • [MeSH-major] Brain Neoplasms / drug therapy. Germinoma / drug therapy. Neoplasm Recurrence, Local
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / administration & dosage. Child. Cisplatin / administration & dosage. Etoposide / administration & dosage. Fatal Outcome. Follow-Up Studies. Humans. Male. Radiotherapy, Adjuvant. Treatment Outcome

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  • (PMID = 12233091.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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12. Radovanovic I, Dizdarevic K, de Tribolet N, Masic T, Muminagic S: Pineal region tumors--neurosurgical review. Med Arh; 2009;63(3):171-3

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pineal region tumors--neurosurgical review.
  • The treatment for the pineal region tumors depends on tumor histology.
  • Nowadays, germinomas can be cured by radiotherapy and chemotherapy without surgical resection but the other pineal region tumors should be primary treated by surgery.
  • Two microsurgical approaches, the infratentorial supracerebellar and the occipital transtentorial, are accepted as the main standard accesses to the pineal region.
  • For benign pineal tumors (pineocytoma, meningioma, mature teratomas, symptomatic pineal cysts, etc.) radical surgical resection can be curative.
  • Serum and CSF markers contribute to the diagnosis of pineal parenchymal tumors. b-HCG is mainly positive in choriocarcinomas, embryonal carcinomas and mixed germ cell tumors and AFP is expressed by yolk sac tumors, embryonic carcinomas, immature teratomas and mixed germ cell tumors, b-HCG is usually low in germinomas which are often positive for PLAP on immunohistochemistry.
  • Fifty-one pineal region tumors were surgically treated by senior author (NdT).
  • Only 17 of them were the neoplasms originating from pineal body (pineal tumors).
  • In conclusion it can be stressed that management of pineal tumors requires a multidisciplinary cooperation.
  • With the exception of germinoma where only a biopsy is needed, the role of the surgeons still remains prominent as resection of pineal tumors requires high technical skill and experience as well as precise clinical judgment.

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  • (PMID = 20088167.001).
  • [Journal-full-title] Medicinski arhiv
  • [ISO-abbreviation] Med Arh
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Bosnia and Herzegovina
  • [Number-of-references] 10
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13. Dhall G, Khatua S, Finlay JL: Pineal region tumors in children. Curr Opin Neurol; 2010 Dec;23(6):576-82
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pineal region tumors in children.
  • PURPOSE OF REVIEW: Pineal tumors are rare in children, with pineoblastoma and germ cell tumors (GCTs) being the most common.
  • Here we discuss recent advances in treatment and controversies in the management of these tumors.
  • Significant controversies exist in the treatment of GCTs as well, including the levels of tumor markers in the blood and cerebrospinal fluid that are required to establish without biopsy the diagnosis of a GCT, the role of surgery in GCTs and the optimal treatment for germinomas as well as mixed malignant GCTs.
  • SUMMARY: Although pineoblastoma in infants and very young children still remains a therapeutic challenge, significant progress has been made in the treatment of pineal GCTs with treatment strategies using a combination of chemotherapy and reduced dose and volume irradiation, resulting in increased survival rates and reduced long-term morbidity.
  • [MeSH-major] Antineoplastic Protocols / standards. Neoplasms, Germ Cell and Embryonal / therapy. Pinealoma / diagnosis. Pinealoma / therapy
  • [MeSH-minor] Age Factors. Antineoplastic Combined Chemotherapy Protocols / standards. Biomarkers, Tumor / blood. Child. Child, Preschool. Diagnosis, Differential. Humans. Infant. Survival Rate / trends. Treatment Outcome

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  • (PMID = 21042218.001).
  • [ISSN] 1473-6551
  • [Journal-full-title] Current opinion in neurology
  • [ISO-abbreviation] Curr. Opin. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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14. Konovalov AN, Pitskhelauri DI: Principles of treatment of the pineal region tumors. Surg Neurol; 2003 Apr;59(4):250-68

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Principles of treatment of the pineal region tumors.
  • BACKGROUND: A pineal region tumor is an uncommon deep-seated, heterogeneous group of mass lesions of the brain, and the management strategy of any types of these tumors remains controversial.
  • METHODS: From 1976 to 1999 about 700 patients with tumors of the pineal region and posterior third ventricle were managed at the Burdenko Neurosurgery Institute.
  • In more than 330 cases the tumor was removed.
  • In this paper we present results of 287 patients with histologically verified pineal region tumors for the period from 1976 to 1999.
  • All of them had verified tumor histology, excluding only five cases in which stereotactic biopsy procedures were uninformative.
  • There are four main groups of tumors: the germ cell tumors-87 (31%); the pineal parenchymal tumors-75 (27%); the glial tumors-77 (27%); and miscellaneous-43 (15%).
  • There were 255 surgical procedures for tumor removal performed in 244 and stereotactically guided biopsies in 61 patients, 168 (58%) with obstructive hydrocephalus who underwent cerebrospinal fluid shunting.
  • Radiation therapy was administered in 145 (51%) and chemotherapy in 16 patients.
  • A total tumor removal was achieved in 148 operations (58%), subtotal in 74 (29%) and partial in 33 (13%).
  • The projected 5-year and 10-year survival rates for patients with malignant pineal tumors, who received irradiation after tumor resection or underwent radiation therapy alone, were: 95% and 88% for pure germinomas, 80% and 50% for high grade gliomas, 44% and 0% for malignant pineal parenchymal tumors, and 20% and 0% for malignant germ cell tumors, respectively.
  • CONCLUSIONS: Benign pineal tumors should be cured with surgery alone.
  • Malignant tumors should be treated with aggressive resection followed with irradiation and chemotherapy.
  • Pure germinomas, which are exquisitely radiosensitive, can be cured by conventional radiation therapy alone.
  • [MeSH-minor] Adolescent. Adult. Animals. Biopsy. Child. Child, Preschool. Female. Humans. Hydrocephalus / etiology. Male. Middle Aged. Prognosis. Retrospective Studies. Stereotaxic Techniques. Survival. Treatment Outcome

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  • (PMID = 12748006.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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15. Kunishio K, Okada M, Miyake K, Matsumoto Y, Nagao S, Nishiyama Y, Ohkawa M: [Report of two cases with germinoma treated by individual adjuvant chemotherapy based on the mRNA expression of drug-resistance gene]. No Shinkei Geka; 2004 Jan;32(1):19-26
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  • [Title] [Report of two cases with germinoma treated by individual adjuvant chemotherapy based on the mRNA expression of drug-resistance gene].
  • We reported two cases with germ cell tumor in which new preliminary treatment trials were performed by chemotherapy using anti-cancer drug selected on the basis of multidrug resistance gene mRNA expression, such as MDR1, MRP1, MRP2, MXR1, MGMT, GST pi and TopoII alpha, from RT-PCR assay.
  • A 28-year-old male had gradually developed DI.
  • MR imaging revealed enhanced tumors in the medulla oblongata, the pineal region and the suprasella region.
  • Biopsy of tumor in the medulla oblongata demonstrated germinoma histologically.
  • RT-PCR assay of this tissue revealed overexpression of MRP1, MGMT and GST pi mRNA, but neither MDR1, MRP2 nor MXR1 was observed.
  • MR imaging revealed enhanced tumor in the pineal region.
  • The tumor was diagnosed as a malignant germ cell tumor, histopathologically.
  • RT-PCR assay of this tissue revealed overexpression of MRP1, MRP2, MXR1, MGMT and GST pi mRNA.
  • The patient was treated by irradiation including radiosurgery combined with chemotherapy, given cisplatin, etoposide and ifosphamide (ICE regimen), but he died because of progressive disease such as CSF dissemination.
  • It seems that preliminary individual adjuvant chemotherapy based on mRNA expression of drug-resistance gene is available for the treatment of germ cell tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / genetics. Brain Neoplasms / therapy. Drug Resistance, Neoplasm / genetics. Gene Expression. Genes, MDR / genetics. Germinoma / genetics. Germinoma / therapy. RNA, Messenger
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Fatal Outcome. Humans. Ifosfamide / administration & dosage. Male. Pharmacogenetics. Treatment Outcome

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  • (PMID = 14978920.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / RNA, Messenger; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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16. Gangemi M, Maiuri F, Colella G, Buonamassa S: Endoscopic surgery for pineal region tumors. Minim Invasive Neurosurg; 2001 Jun;44(2):70-3
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  • [Title] Endoscopic surgery for pineal region tumors.
  • Endoscopic surgery may play an important role in most patients with pineal region tumors.
  • The procedure included in all cases third ventriculostomy for the correction of hydrocephalus, CSF sample for cytology and tumor markers, and tumor biopsy for histological diagnosis.
  • We agree that endoscopic surgery may allow us to select cases requiring a microsurgical approach (medium-sized or large non-germ-cell tumors) from cases to be treated only by irradiation and chemotherapy (germinomas and other non-germ-cell tumors).
  • Then, in some patients with pineal region tumors the endoscopic procedure remains the only surgical treatment.
  • [MeSH-major] Astrocytoma / surgery. Brain Neoplasms / surgery. Endoscopy / methods. Germinoma / surgery. Pineal Gland / surgery. Pinealoma / surgery

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  • (PMID = 11487787.001).
  • [ISSN] 0946-7211
  • [Journal-full-title] Minimally invasive neurosurgery : MIN
  • [ISO-abbreviation] Minim Invasive Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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17. Oi S, Shibata M, Tominaga J, Honda Y, Shinoda M, Takei F, Tsugane R, Matsuzawa K, Sato O: Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study. J Neurosurg; 2000 Aug;93(2):245-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study.
  • OBJECT: This prospective study is based on a consecutive series of 20 patients with pineal region tumors who underwent minimally invasive preferential management.
  • The purpose of this report is to discuss the role of neuroendoscopic procedures in the management of pineal region tumors.
  • METHODS: If the tumor markers alpha-fetoprotein and human chorionic gonadotropin were not detected in serum and there was significant ventricular dilation visualized on neuroimages, neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third ventriculostomy.
  • For treatment of germinomas and pineoblastomas, if no tumor dissemination was confirmed by pre-, intra-, or postoperative findings, stereotactic radiotherapy or radiosurgery was performed after one course of chemotherapy with the ICE regimen (isofomid, cisplatin, and etoposide) and followed by two additional courses of chemotherapy.
  • For treatment of malignant germ cell tumors, after extensive surgery, adjuvant chemotherapy with the ICE regimen was performed in three courses in all cases.
  • Then radiotherapy was started using various methods, depending on the evidence of tumor dissemination.
  • For treatment of teratomatous and neuroectodermal tumors other than pineoblastomas, extensive surgical removal was performed.
  • As for adjuvant therapy, if the tumor was a low-grade glioma or if the patient was younger than 5 years of age, postoperative treatment did not include radiotherapy.
  • If the tumor was a malignant teratoma or high-grade glioma, conventional focal radiotherapy was performed, followed by chemotherapy with ICE for 1 year.
  • Neuroendoscopic biopsy with tumor debulking offered enough material for tissue diagnosis, including immunohistochemical analysis and, in one case, revealed evidence of tumor dissemination undetectable on neuroimaging.
  • Favorable therapeutic outcomes were obtained in all cases of germinoma and pineoblastoma, with follow-up periods ranging from 24 months to 6.5 years.
  • CONCLUSIONS: Our minimally invasive preferential regimen clarified the precise indication for neuroendoscopic procedures, and the majority of our patients with dilated ventricles and no evidence of tumor markers were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure, avoiding unnecessary craniotomy and radiotherapy and promising excellent therapeutic outcomes.
  • The treatment for malignant pineal region tumors remains a subject for further study.
  • [MeSH-major] Brain Neoplasms / surgery. Endoscopy. Minimally Invasive Surgical Procedures. Pineal Gland / surgery. Pinealoma / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Child. Female. Glioma / pathology. Glioma / surgery. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy, Adjuvant. Risk Factors. Treatment Outcome

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  • (PMID = 10930010.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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18. Peltier J, Vinchon M, Baroncini M, Kerdraon O, Dhellemmes P: Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report. J Neurooncol; 2008 Oct;90(1):111-5
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  • [Title] Bifocal mixed germ-cell tumor with growing teratoma syndrome and metachronous mature metastases: case report.
  • The authors report the case of a 16-year-old male who presented with a bifocal diencephalic tumor arising both in the neurohypophysis and the pineal region with hydrocephalus.
  • The histological diagnosis obtained during endoscopic ventriculocisternostomy was germinoma.
  • MRI revealed an increase of the neoplasm during chemotherapy with recurrent obstructive hydrocephalus.
  • Subsequently, this patient developed metachronous cystic metastases in the cerebello-pontine angles, which were resected and identified as mature teratoma, then we observed a lesion of the brachium conjunctivum which stayed stable after 29 consecutive months.
  • The patient is alive and feels well 6 years after the initial diagnosis and 5 years after the first metastasis.
  • Obviously surgical removal is the treatment of reference for teratomas.
  • Primary intracranial germ-cell tumors (CGT) arise in the midline of the brain and are located in the diencephalon.
  • Germ cell tumor (CGT) includes germinomas and non-germinomatous tumors, mature and immature teratomas account for 19.6 % [1].
  • Curiously, teratomas are able to grow during the first weeks of chemotherapy while serum markers remain normal.
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Humans. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Pineal Gland / pathology. Pineal Gland / physiopathology

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  • [CommentIn] J Neurooncol. 2009 Sep;94(3):449-50 [19347253.001]
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  • (PMID = 18574668.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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19. Hanna A, Edan C, Heresbach N, Ben Hassel M, Guegan Y: [Expanding mature pineal teratoma syndrome. Case report]. Neurochirurgie; 2000 Dec;46(6):568-572
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  • [Title] [Expanding mature pineal teratoma syndrome. Case report].
  • We present a case of growing teratoma syndrome of the pineal region.
  • CT scan showed a pineal region tumor with obstructive hydrocephalus.
  • After CSF (cerebrospinal fluid) shunting, MRI showed that the tumor had a heterogenous signal enhancement.
  • The tumor marker HCG (human chorionic gonadotrophin) was elevated in CSF and serum.
  • After three cycles of chemotherapy, MRI showed an important increase in tumor size with morphologic modifications.
  • On postoperative MRI, there was a small area of signal enhancement of the left thalamus.
  • The child was in complete remission 15 months after the diagnosis.
  • Growing teratoma syndrome is a mixed germ cell tumor with a secreting portion that responds to chemotherapy and a non secreting portion of mature teratoma that continues to grow under chemotherapy.
  • The treatment should include chemotherapy for the malignant secreting portion and surgery for the mature teratoma.
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / analysis. Cerebrospinal Fluid Shunts. Chorionic Gonadotropin / blood. Chorionic Gonadotropin / cerebrospinal fluid. Chorionic Gonadotropin / secretion. Combined Modality Therapy. Diagnosis, Differential. Diplopia / etiology. Etoposide / administration & dosage. Germinoma / diagnosis. Humans. Ifosfamide / administration & dosage. Intracranial Hypertension / etiology. Magnetic Resonance Imaging. Male. Neoplasm Invasiveness. Neoplasm Proteins / blood. Neoplasm Proteins / cerebrospinal fluid. Neoplasm Proteins / secretion. Radiotherapy, Adjuvant. Remission Induction. Thalamus / pathology

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  • (PMID = 11148410.001).
  • [ISSN] 0028-3770
  • [Journal-full-title] Neuro-Chirurgie
  • [ISO-abbreviation] Neurochirurgie
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / Neoplasm Proteins; 6PLQ3CP4P3 / Etoposide; UM20QQM95Y / Ifosfamide
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20. Amendola BE, Wolf A, Coy SR, Amendola MA, Eber D: Pineal tumors: analysis of treatment results in 20 patients. J Neurosurg; 2005 Jan;102 Suppl:175-9

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pineal tumors: analysis of treatment results in 20 patients.
  • OBJECT: The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with tumors in the pineal region.
  • METHODS: This is a retrospective clinical evaluation of 20 patients with primary tumors of the pineal region treated with GKS from November 1994 through August 2003.
  • There were 13 germ cell tumors, two pineoblastomas, two low-grade gliomas, one primitive neuroectodermal tumor, one teratoma, and one pineocytoma.
  • The median margin dose was 11 Gy (range 8-20 Gy).
  • Five patients received sequential systemic chemotherapy and four underwent adjuvant conventional radiation therapy.
  • Three patients died: one of unrelated causes, one who presented with extensive local disease, and the other of meningeal carcinomatosis with local control of the primary tumor.
  • CONCLUSIONS: This initial experience suggests that GKS is a valuable treatment modality for the management of pineal region tumors.
  • This technique offers excellent local tumor control and minimal patient morbidity, allowing for immediate use of systemic chemotherapy and/or conventional radiation if indicated.
  • [MeSH-minor] Adolescent. Adult. Aged. Child. Child, Preschool. Diagnosis, Differential. Female. Glioma / mortality. Glioma / pathology. Glioma / surgery. Humans. Hydrocephalus / pathology. Magnetic Resonance Imaging. Male. Middle Aged. Neuroectodermal Tumors, Primitive / mortality. Neuroectodermal Tumors, Primitive / pathology. Neuroectodermal Tumors, Primitive / surgery. Radiation Dosage. Retrospective Studies. Survival Rate. Teratoma / mortality. Teratoma / pathology. Teratoma / surgery

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  • (PMID = 15662805.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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21. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD: Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases. Pediatr Neurosurg; 2003 Jun;38(6):329-33
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  • [Title] Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases.
  • In this study, we evaluated the results in four patients with nongerminomatous germ cell tumors (NGGCT) of the pineal region.
  • All underwent radiosurgery in conjunction with surgical resection, fractionated radiotherapy or chemotherapy.
  • Four male patients with pineal region NGGCT were treated with radiosurgery.
  • One patient was diagnosed by serum and CSF tumor markers.
  • The mean tumor volume was 10.5 cm(3).
  • Radiosurgery was performed with mean maximum and marginal doses of 28 and 14 Gy, respectively.
  • The mean follow-up after diagnosis and after radiosurgery was 34 and 25 months, respectively.

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12759512.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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22. Maruki C, Takara K, Abe K, Tsunoda A, Ebato M, Ikeya F: [Primary pineal embryonal carcinoma occurring in a middle aged man]. No Shinkei Geka; 2000 Oct;28(10):909-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Primary pineal embryonal carcinoma occurring in a middle aged man].
  • A case of a primary pineal embryonal carcinoma occurring in a middle aged man is reported.
  • Head CT and MRI showed a tumor in the pineal region.
  • The tumor was partially removed and an intra-operative specimen was used to diagnose a kind of germ cell line tumor.
  • However, the tumor was diagnosed afterwards as a pure embryonal carcinoma.
  • Three courses of PE chemotherapy followed by 30 Gy of whole craniospinal irradiation and 30 Gy of extended local irradiation were completed.
  • An MRI showed the tumor to be in complete remission.
  • Despite careful follow-up with chemotherapy every three months, a re-operation and linac radio-surgery, the tumor recurred, and disseminated.
  • A pure primary pineal embryonal carcinoma occurring in a middle-aged person has never been reported previously in detail.
  • [MeSH-major] Brain Neoplasms / etiology. Carcinoma, Embryonal / etiology. Pineal Gland

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  • (PMID = 11070913.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] JAPAN
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23. Voirin J, Klein O, Chastagner P, Moret C, Vignaud JM, Auque J, Marchal JC: [Germ-cell tumors of the central nervous system in childhood: retrospective study of 13 patients]. Neurochirurgie; 2008 Apr;54(2):55-62
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  • [Title] [Germ-cell tumors of the central nervous system in childhood: retrospective study of 13 patients].
  • [Transliterated title] Les tumeurs germinales du système nerveux central de l'enfant : étude rétrospective de 13 patients.
  • BACKGROUND AND PURPOSE: Germ cell tumors (GCT) of the central nervous system are rare (2% of all brain tumors in children).
  • Although originating from germ cells, GCT cover a spectrum of different tumors with different management and prognosis, depending on whether they secrete tumor markers or not.
  • RESULTS: Median age at diagnosis is 12.9 years (7-17 years).
  • Tumor markers (alpha foetoprotein [alphaFP], human chorionic gonadotrophin [betaHCG]) were assessed 11 times in blood as well as cerebrospinal fluid (CSF).
  • Tumors were located as follows: pineal region (10 cases), hypothalamus (eight cases), basal ganglia (one case) and corpus callosum (one case).
  • Six were bifocal (pineal region and hypothalamus).
  • Tumor markers were positive in three cases and these children subsequently received chemotherapy followed by radiotherapy, except one child.
  • The eight other patients had a stereotactic biopsy for diagnosis.
  • At the end of follow-up, treatment morbidity appears to be low and neither death nor recurrence was observed.
  • Surgery is crucial for diagnosis in the event of negative markers, or if there is evidence of residual tumor with normalization of tumor markers at the end of chemotherapy.
  • Tumor markers must be monitored to check the diagnosis and for follow-up.
  • The place of tumor biopsy during endoscopic third ventriculostomy (performed if hydrocephalus is present) is still debated.
  • [MeSH-major] Brain Neoplasms / therapy. Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Biomarkers, Tumor. Biopsy. Child. Combined Modality Therapy. Female. Humans. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Prognosis. Retrospective Studies. Stereotaxic Techniques. Survival Analysis. Tomography, X-Ray Computed. Ventriculostomy

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  • (PMID = 18355878.001).
  • [ISSN] 0028-3770
  • [Journal-full-title] Neuro-Chirurgie
  • [ISO-abbreviation] Neurochirurgie
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor
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24. Sugimoto K, Nakahara I, Nishikawa M: Bilateral metachronous germinoma of the basal ganglia occurring long after total removal of a mature pineal teratoma: case report. Neurosurgery; 2002 Mar;50(3):613-6; discussion 616-7
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  • [Title] Bilateral metachronous germinoma of the basal ganglia occurring long after total removal of a mature pineal teratoma: case report.
  • OBJECTIVE AND IMPORTANCE: We report the extremely rare occurrence of a second germ cell tumor at a different site and with different histological types long after total removal of a mature pineal teratoma.
  • Neuroradiological studies revealed a tumor in the pineal region.
  • The tumor was totally removed.
  • Histologically, the tumor proved to be a mature teratoma.
  • The patient received no adjuvant therapy and was followed in the outpatient clinic.
  • Neuroradiological studies showed a tumor in the bilateral basal ganglia.
  • INTERVENTION: The second tumor, which was located in the right basal ganglion, was partially removed for biopsy.
  • Histologically, the tumor proved to be a germinoma.
  • The patient received three cycles of combination chemotherapy consisting of carboplatin and etoposide with radiotherapy.
  • After the second course of chemotherapy, magnetic resonance imaging studies revealed no evidence of the tumor.
  • CONCLUSION: The second tumor was considered to be a de novo metachronous neoplasm rather than a recurrence of the original mature teratoma.
  • We think that if primordial germ cell groups exist along the midline of the brain, more than two primordial germ cell groups could give rise to metachronous neoplasms at different sites and with different histological types.
  • [MeSH-major] Basal Ganglia Diseases / surgery. Brain Neoplasms / surgery. Germinoma / surgery. Neoplasms, Second Primary. Pineal Gland / surgery. Teratoma / surgery
  • [MeSH-minor] Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Child. Combined Modality Therapy. Etoposide / administration & dosage. Humans. Magnetic Resonance Imaging. Male

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  • (PMID = 11841731.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Phytogenic; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
  • [Number-of-references] 11
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25. Kiratli H, Erkan Balci K, Güler G: Primary orbital endodermal sinus tumor (yolk sac tumor). J AAPOS; 2008 Dec;12(6):623-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary orbital endodermal sinus tumor (yolk sac tumor).
  • Endodermal sinus tumor, or yolk sac tumor, is the most common malignant neoplasm of germ cell origin and usually occurs in infant testes or ovaries.
  • On rare occasions, the tumor may arise from extragonadal sites, including sacrococcygeal region, uterus, vagina, prostate, retroperitoneum, liver, mediastinum, pineal gland, and third ventricle.
  • The orbit is an unusual location for the primary development of this neoplasm.
  • We report the case of a girl with primary orbital endodermal sinus tumor who was managed with exenteration and chemotherapy with the result of a disease-free survival of 9 years.

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  • (PMID = 18835732.001).
  • [ISSN] 1528-3933
  • [Journal-full-title] Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
  • [ISO-abbreviation] J AAPOS
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Phytogenic; 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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26. Zanetta F, Di Dio G, Savastio S, Saccagno A, Petri A, Bellone S, Maghnie M, Bona G: [Germinoma: a rare cerebral tumor causing central diabetes insipidus in childhood]. Minerva Pediatr; 2008 Feb;60(1):129-33
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  • [Title] [Germinoma: a rare cerebral tumor causing central diabetes insipidus in childhood].
  • Germinoma represents 7.8% of cerebral tumors in pediatric age and 50-65% of germ cell cerebral tumors.
  • Generally it is a definite lesion of the pineal gland or suprasellar region, frequently occurring in the first three decades of life.
  • Clinical presentation depends on tumor localization.
  • Pineal lesions generally determine symptoms due to the compression of cerebral structures, causing Parinaud syndrome, while hypothalamic lesions are often characterized by diabetes insipidus, hypopituitarism and visual defects.
  • In the absence of these classic signs and symptoms, however, the diagnosis of germinoma can be difficult.
  • Magnetic resonance imaging (MRI) showed a lack of posterior pituitary gland and partial pituitary stalk enlargement.
  • The patient started therapy with desmopressin (Minirin) with good hydro-electrolytic balance.
  • A second MRI demonstrated a bifocal lesion with dyshomogeneous and cystic appearance, suggesting the diagnosis of germinoma.
  • On the basis of this case report we would like to point out the importance of an early diagnosis in order to improve the prognosis of the disease and the necessity of a careful follow-up of these patients.
  • [MeSH-major] Diabetes Insipidus / diagnosis. Diabetes Insipidus / etiology. Germinoma / complications. Germinoma / diagnosis. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis
  • [MeSH-minor] Antidiuretic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Deamino Arginine Vasopressin / therapeutic use. Diagnosis, Differential. Drug Therapy, Combination. Humans. Male. Treatment Outcome

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  • (PMID = 18277371.001).
  • [ISSN] 0026-4946
  • [Journal-full-title] Minerva pediatrica
  • [ISO-abbreviation] Minerva Pediatr.
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antidiuretic Agents; ENR1LLB0FP / Deamino Arginine Vasopressin
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27. Kohyama S, Uematsu M, Ishihara S, Shima K, Tamai S, Kusano S: An experience of stereotactic radiation therapy for primary intracranial choriocarcinoma. Tumori; 2001 May-Jun;87(3):162-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] An experience of stereotactic radiation therapy for primary intracranial choriocarcinoma.
  • We report on a patient with choriocarcinoma in the pineal region who was successfully treated with stereotactic radiation therapy (SRT).
  • The increased level of serum human chorionic gonadotropin (HCG) was lowered during chemotherapy with etoposide, cisplatin, and ifosfamide.
  • However, HCG was not normalized and magnetic resonance images still showed an enhanced tumor mass with gadolinium.
  • The patient underwent SRT of 40 Gy at an 80% isodose line per 10 fractions over two weeks, followed by conventional craniospinal irradiation of 32.4 Gy.
  • The level of HCG dropped below the detection limit.
  • The patient has been in good condition for more than four years after the completion of treatment, without any signs of recurrence.
  • We propose SRT as a valid treatment option for malignant germ cell tumors in the pineal region.
  • [MeSH-minor] Adult. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 11504371.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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