Download PDF
Minim Invasive Neurosurg 2006; 49(4): 247-250
DOI: 10.1055/s-2006-948301
Case Report

© Georg Thieme Verlag KG · Stuttgart · New York

Neuroendoscopic Management of a Solitary Pineal Region Tumor. Case Report of an Adenocarcinoma Metastasis

D. Boscherini 1 , M. Pintucci 1 , L. Mazzucchelli 2 , R. Renella 1 , G. Pesce 3
  • 1Servizio Cantonale di Neurochirurgia, Ospedale Regionale Lugano, Lugano, Switzerland
  • 2Servizio Cantonale di Patologia, Locarno, Switzerland
  • 3Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
Further Information

Publication History

Publication Date:
13 October 2006 (online)

    Permissions and Reprints

Abstract

The present case describes a two-step endoscopic management of hydrocephalus and diagnosis of a single pineal region metastasis arising from a gastric adenocarcinoma. A 62-year-old man presenting with signs of subacute obstructive hydrocephalus from a pineal region mass had at first been treated with an endoscopic third ventriculostomy. As cerebrospinal fluid tumor markers (alpha-fetoprotein, beta-human chorionic gonadotropin) were negative, an endoscopic biopsy of the pineal region tumor was performed through a more anterior frontal burr hole. Pathology showed an adenocarcinoma and primary tumor work-up revealed an unsuspected gastric tumor, the pathology of which matched with the intracranial metastasis. The present report emphasizes the role of neuroendoscopy in pineal region tumors and reports a rare case of a solitary gastric adenocarcinoma metastasis in this location.

Key words

Minimally invasive - neuroendoscopy - pineal region - metastasis

References

  • 1 Bruce JN. Management of pineal region tumors.  Neurosurg Quart. 1983;  3 103-119
    PubMedGoogle Scholar
  • 2 Stein BM, Bruce JN. Surgical management of pineal region tumors -honoured guest lecture.  Clin Neurosurg. 1992;  39 509-532
    PubMedGoogle Scholar
  • 3 Choi JU, Kim DS, Chung SS, Kim TS. Treatment of germ cell tumors in the pineal region.  Childs Nerv Syst. 1998;  14 1-2 , and 41-48
    CrossrefPubMedGoogle Scholar
  • 4 Kashiwagi S, Hatano M, Yokoyama T. Metastatic small cell carcinoma to the pineal body. Case report.  Neurosurgery. 1989;  25 810-813
    PubMedGoogle Scholar
  • 5 Brasseur P, Sukkarieh F, Dupont H, Brohee D. Pineal body metastasis.  J Belge Radiol. 1994;  77 162-163
    PubMedGoogle Scholar
  • 6 Bruner JM, Tien RD. Secondary tumors. In: Bigner DD, Mc Lendon RE, Bruner JM (eds). Russell and Rubinstein's Pathology of Tumors of the Nervous System. Vol. 2 London, Arnold 1998: 419-450
    Google Scholar
  • 7 Cohen AR. Endoscopic ventricular surgery.  Pediatric Neurosurg. 1993;  19 127-134
    PubMedGoogle Scholar
  • 8 Bauer BL, Hellwig D. Minimally invasive endoscopic neurosurgery - a survey.  Acta Neurochir Suppl. 1994;  61 1-12
    PubMedGoogle Scholar
  • 9 Edwards MSB, Hudgins RJ, Wilson CB. et al . Pineal region tumors in children.  J Neurosurg. 1988;  68 689-697
    Google Scholar
  • 10 Oi S, Matsuzawa K, Choi JU. et al . Identical characteristics of the patient populations with pineal region tumors in Japan and in Korea and therapeutic modalities.  Childs Nerv Syst. 1998;  14 36-40
    CrossrefPubMedGoogle Scholar
  • 11 Oi S, Shibata M, Tominaga J. et al . Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study.  J Neurosurg. 2000;  93 245-253
    CrossrefPubMedGoogle Scholar
  • 12 Regis J, Bouillot P, Rouby-Volot F. et al . Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases.  Neurosurgery. 1996;  39 907-912 , discussion 912-914
    PubMedGoogle Scholar
  • 13 Favre J, Taha JM, Burchiel KJ. An analysis of the respective risks of hematoma formation in 361 consecutive morphological and functional stereotactic procedures.  Neurosurgery. 2002;  50 48-56 , discussion 57
    PubMedGoogle Scholar
  • 14 Keyaki A, Makita Y, Nabeshima S. et al . Pineal metastatic tumor from lung cancer initially caused by neurological abnormalities of pineal body tumor.  No Shinkei Geka. 1989;  17 495-499
    PubMedGoogle Scholar
  • 15 Ramina R, Coelho Neto M, Mariushi WM. et al . Pineal metastasis as first clinical manifestation of colorectal adenocarcinoma.  Case report. Arq Neuropsiquiatr. 1999;  57 92-95
    PubMedGoogle Scholar
  • 16 Schuster JM, Rostomily RC, Hahn C. et al . Two cases of esophageal carcinoma metastatic to the pineal region with a review of the literature.  Surg Neurol. 1998;  49 100-103
    CrossrefPubMedGoogle Scholar
  • 17 Vaquero J, Martinez R, Magallon R, Ramiro J. et al . Intracranial metastases to the pineal region. Report of three cases.  J Neurosurg Sci. 1991;  35 55-57
    PubMedGoogle Scholar
  • 18 Weber P, Shepard KV, Vijayakumar S. Metastases to pineal gland.  Cancer. 1989;  63 164-165
    CrossrefPubMedGoogle Scholar
  • 19 Halpert B, Erickson EE, Fields WS. Intracranial involvement form carcinoma of the lung.  AMA Arch Pathol. 1960;  69 93-103
    PubMedGoogle Scholar
  • 20 Ortega P, Malamud N, Shinkin M. Metastasis to the pineal body.  Arch Pathol. 1951;  52 518-528
    PubMedGoogle Scholar
  • 21 Kakita A, Kobayashi K, Aoki N, Eguchi I, Morita T, Takahashi H. Lung carcinoma metastasis presenting as a pineal region tumor.  Neuropathology. 2003;  23 57-60
    CrossrefPubMedGoogle Scholar
  • 22 Lauro S, Trasatti L, Capalbo C, Mingazzini PL, Vecchione A, Bosman C. Unique pineal gland metastasis of clear cell renal carcinoma: case report and review of the literature.  Anticancer Res. 2002;  22 3077-3079
    PubMedGoogle Scholar
  • 23 Umahara T, Kikawada M, Arai H, lwamoto T, Takasaki M, Hirabayashi Y, Kudo M, Tsuchiya K, Shimada H. An autopsy case of multiple myeloma with pineal body and spinal cord dura mater infiltration.  No To Shinkei. 1997;  49 655-658
    PubMedGoogle Scholar
  • 24 Enriquez R, Egbert B, Bullock J. Primary malignant melanoma of central nervous system. Pineal involvement in a patient with nevus of ota and multiple pigmented skin nevi.  Arch Pathol. 1973;  95 392-395
    PubMedGoogle Scholar
  • 25 Czirjak S, Vitanovic D, Slowik F, Magyar A. Primary meningeal melanocytoma of the pineal region. Case report.  J Neurosurg. 2000;  92 461-465
    PubMedGoogle Scholar

Correspondence

Dr. med. Duccio Boscherini

c/o Servizio Cantonale di Neurochirurgia

Ospedale Regionale Lugano

Via Tesserete 46

6900 Lugano

Switzerland

Phone: +41/91/811/64 55

Fax: +41/91/811/64 64

Email: duccio.boscherini@eoc.ch

      >