title: Neuroendoscopic management of a solitary pineal region tumor. Case report of an adenocarcinoma metastasis.
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.
authors.affiliation: Servizio Cantonale di Neurochirurgia, Ospedale Regionale Lugano, Lugano, Switzerland. duccio.boscherini@eoc.ch
authors.forename: D
authors.initials: D
authors.lastname: Boscherini
authors.forename: M
authors.initials: M
authors.lastname: Pintucci
authors.forename: L
authors.initials: L
authors.lastname: Mazzucchelli
authors.forename: R
authors.initials: R
authors.lastname: Renella
authors.forename: G
authors.initials: G
authors.lastname: Pesce
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000134:cerebrospinal fluid; D002535:Cerebral Aqueduct / Q000473:pathology / Q000503:physiopathology; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods* / Q000592:standards; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D010870:Pineal Gland / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010871:Pinealoma / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology*; D020542:Third Ventricle / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor