Surgical management of pineal region tumors.
The authors advocate an aggressive surgical approach to pineal region tumors to provide a definitive histological diagnosis and to facilitate extensive tumor removal. This strategy is based on their surgical experience in 160 operations for pineal region tumors in which operative mortality was 4% with 3% permanent major morbidity. One-third of pineal tumors were benign for which surgery alone was usually curative. A gross total removal was possible in 31 of 107 malignant tumors. The supracerebellar infratentorial approach was preferred in 86% of patients. The tumors displayed considerable histological diversity with germ cell tumors most common (37%), followed by glial cell tumors (28%) and pineal cell tumors (23%). Mixed tumors occurred 15% of the time. Spinal metastases were rare, occurring in less than 10% of patients with malignant tumors. These results with a large series of pineal region tumors demonstrate the safety and efficacy of aggressive pineal tumor surgery.
Bruce
J N
JN
Department of Neurosurgery, New York Neurological Institute, Columbia University College of Phyicians and Surgeons, New York, USA.
Stein
B M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000601:surgery*; D010871:Pinealoma / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications