CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2020; 09(01): 55-57
DOI: 10.1055/s-0039-1698846
Case Report

Pineal Parenchymal Tumor with Intermediate Differentiation—A Case Report and Review of Literature from Rural India

Raj Kumar
1   Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
,
Seema Dayal
2   Department of Pathology, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
,
Mani Krishna
1   Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
› Institutsangaben

Abstract

Pineal gland tumors are rare tumors. According to World Health Organization (WHO) classification (2016) of the central nervous system, pineal parenchymal tumors of intermediate differentiation (PPTID) occupied their position between pineocytoma and pineoblastoma. It is either grade II or III. There are small numbers of reported cases, so its classification is still a matter of controversy. Here, we report a case of a 35-year-old man who presented with complaints of headache, nausea, vomiting, and focal weakness for 1 year. Computed tomography revealed an enhancing mass lesion in the region of pineal gland along with hydrocephalus. Following operation, histopathology of excised specimen was done, and it showed cellular tumor. Cells were having larger nuclei, vesicular chromatin pattern, ample cytoplasm, focal neuropil-like stroma along with moderate atypia, 3 to 5 mitotic figures per 10 hpf (high-power field), marked vascular proliferation, and pseudo rosette. Immunohistochemistry was found strongly positive for glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE), variable for synaptophysin, and negative for neurofilament and epithelial membrane antigen (EMA). These findings confirmed the diagnosis. As this tumor is rare with uncertain behavior following available treatment, the case report of PPTID grade III large cell type may enrich the existing data and is being presented because of its rarity.



Publikationsverlauf

Artikel online veröffentlicht:
09. Dezember 2019

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Gasparetto EL, Warszawiak D, Adam GP, Bleggi-Torres LF, de Carvalho Neto A. Glioblastoma multiforme of the pineal region: case report. Arq Neuropsiquiatr 2003; 61 (2B): 468-472
  • 2 Jouvet A, Saint-Pierre G, Fauchon F. et al. Pineal parenchymal tumors: a correlation of histological features with prognosis in 66 cases. Brain Pathol 2000; 10 (01) 49-60
  • 3 Fauchon F, Jouvet A, Paquis P. et al. Parenchymal pineal tumors: a clinicopathological study of 76 cases. Int J Radiat Oncol Biol Phys 2000; 46 (04) 959-968
  • 4 Mena H, Nakazato Y, Jouvet A. Pineal parenchymal tumours. In: Kleiheus P, Cavenee WK. eds. The WHO Classification of Tumours of the Central Nervous System. Lyon, France: IARC Press; 2002: 115-122
  • 5 Nakazato Y, Jouvet A, Scheitauer BW. Pineal parenchymal tumor of intermediate differentiation. In: Louis DN. ed. World Health Organization Classification of Tumours of the Central Nervous System. 4th ed. Vol. 7. WHO; 2007: 124-125
  • 6 Amendola BE, Wolf A, Coy SR, Amendola MA, Eber D. Pineal tumors: analysis of treatment results in 20 patients. J Neurosurg 2005; 102 (Suppl): 175-179
  • 7 Komakula S, Warmuth-Metz M, Hildenbrand P. et al. Pineal parenchymal tumor of intermediate differentiation: imaging spectrum of an unusual tumor in 11 cases. Neuroradiology 2011; 53 (08) 577-584
  • 8 Mallick S, Benson R, Rath GK. Patterns of care and survival outcomes in patients with pineal parenchymal tumor of intermediate differentiation: an individual patient data analysis. Radiother Oncol 2016; 121 (02) 204-208
  • 9 Patil M, Karandikar M. Pineal parenchymal tumor of intermediate differentiation. Indian J Pathol Microbiol 2015; 58 (04) 540-542
  • 10 Khaled A, Joarder MA, Chandy M, Nasir TA. Pineal parenchymal tumour of intermediate differentiation: a case report. Pulse 2013; 6 (1-2): 60-61
  • 11 Kiyici H, Sanal B. Pineal parenchymal tumor of intermediate differentiation: a brief report. Eur J Basic Med Sci 2012; 2 (01) 30-33
  • 12 Raleigh DR, Solomon DA, Lloyd SA. et al. Histopathologic review of pineal parenchymal tumors identifies novel morphologic subtypes and prognostic factors for outcome. Neuro-oncol 2017; 19 (01) 78-88
  • 13 Amato-Watkins AC, Lammie A, Hayhurst C, Leach P. Pineal parenchymal tumours of intermediate differentiation—an evidence-based review of a new pathological entity. Br J Neurosurg 2016; 30 (01) 11-15
  • 14 Schild SE, Scheithauer BW, Schomberg PJ. et al. Pineal parenchymal tumors. Clinical, pathologic, and therapeutic aspects. Cancer 1993; 72 (03) 870-880