Glioblastoma multiforme of the pineal region: case report.
OBJECTIVE
pineal region tumors are uncommon, and comprise more frequently three categories: germ cell, parenchymal cell and glial tumors. Most pineal gliomas are low-grade astrocytomas. Glioblastoma multiforme, the most aggressive and common brain tumor, is extremely rare at this location with only few cases reported.


METHODS
a 29-year-old woman with a two month history of headache, nuchal pain, fever, nausea and seizures and physical examination showing nuchal rigidity, generalized hypotony, hypotrophy and hyper-reflexia, Babinski sign and left VI cranial par palsy. CT scan examination revealed a ill-defined hypodense lesion at the pineal region with heterogeneous contrast enhancement. MRI showed a lesion at the pineal region infiltrating the right thalamic region. The patient underwent a right craniotomy with partial resection of the mass. The histological examination of paraffin-embedded material defined the diagnosis of glioblastoma multiforme. Post-operative radiotherapy was indicated but the patient refused the treatment and died two months afterwards.


CONCLUSIONS
in spite of its rarity at this location, glioblastoma multiforme should be considered in the differential diagnosis of aggressive lesions at the pineal region.
Gasparetto
Emerson Leandro
EL
Discipline of Diagnostic radiology, Department of Pathology, , University of Parana school of Medicine, Curitiba PR,l Brazil. gasparetto@hotmail.com
Warszawiak
Danny
D
Adam
Guilherme Pradi
GP
Bleggi-Torres
Luiz Fernando
LF
de Carvalho Neto
Arnolfo
A
D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D010870:Pineal Gland / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed