Looking for experience in the endoscopic resection of a PPTID, grade 2 pineal tumors compared to the traditional approach.
Since it is an extremely rare tumor any expertise/ advice is welcome.
Background.
A 55 year old caucasian Dutch woman presented herself with speech disorder, vision problems and headaches.Neurological evaluation resulted in a tumor mass, chestnut size, in the pineal region.
An endoscopic procedure gave a smooth rounded tumor. Little bleeding after multiple biopsy. Third ventriculostomy was performed after which patient condition improved up to normal function.
PA: PPTID, grade 2, mitosis 4.
2 ARTICLES:
1.
Histological diagnosis was obtained in 32/34 (94%) of the cases. (Read More: http://informahealthcare.com/doi/abs/10.1080/02688690120072441)
2.
Results
In the PPTID cases, the extent of resection was variable and the recurrence rates among patients varied according to stage and treatment. All PC patients underwent total resection with no recurrence. All PB patients underwent resection and adjuvant therapy with radiotherapy and chemotherapy. There were no recurrences in patients with PC or PB. The results of histopathologic findings have been already reported as mentioned above. Briefly, the results indicated no mitotic figure or necrosis in any of the six cases of PPTID, but those features were observed in PB cases. All cases even including PC and PB were immunopositive for neuronal markers. The MIB-1 labeling index of PPTID was 3.5%, whereas it was 0% in PC and 10.5% in PB.
Conclusions
Good radiosensitivity of PPTIDs was observed in our series. Because there are cases with discrepancies between images and pathologic findings, it is very difficult to determine the proper treatment strategy for PPTIDs. Proliferative potential was correlated with World Health Organization grade, although the immunoreactivity of neuronal markers did not correlate with the histologic grade.
http://www.worldneurosurgery.org/article/S1878-8750%2813%2900272-6/pdf
Prof. Huib Schut, i hope u have already seen this video (only few mins)
http://www.skullbaseinstitute.com/video-pineal-tumor.htm
Also a full text article from the same author attached..
Those two articles seems good, the first one is a review with 66 cases.Hope this will help.Regards
http://www.ncbi.nlm.nih.gov/pubmed/19329859
http://www.ncbi.nlm.nih.gov/pubmed/18266015
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