title: Atypical pleomorphic neoplasms of the pineal gland: Case report and review of the literature.
abstract: BACKGROUND
  Pineal region tumors are rare and diverse. Among them exist reports of pleomorphic xanthroastrocytoma (PXA) and pleomorphic granular cell astrocytoma (PGCA) of the pineal gland. These related tumors are remarkably similar sharing pleomorphic histologic features with only minor immunohistochemical and ultrastructural differences.
  
  
  METHODS
  We present a case of a 42-year old right-handed woman presented with a longstanding history of migraine headaches which had worsened over the two months leading up to her hospitalization. MRI revealed a 1.7 × 1.3 × 1.6 cm intensely enhancing lesion originating in the pineal gland. The tumor closely resembled PGCA but did not strictly fit the diagnostic requirements of either PGCA or PXA.
  
  
  CONCLUSIONS
  The present case highlights the exotic nature of pineal region tumors with pleomorphic cell histology. Given the diverse range of tumors encountered in the pineal region, pathological confirmation is mandatory. Favorable clinical outcomes demonstrate that surgical resection alone can yield excellent long-term results for tumors falling within the spectrum of pleomorphic lesions of the pineal gland.
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Praver
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: R
authors.initials: R
authors.lastname: D'Amico
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: C
authors.initials: C
authors.lastname: Arraez
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: B E
authors.initials: BE
authors.lastname: Zacharia
authors.affiliation: Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
authors.forename: H
authors.initials: H
authors.lastname: Varma
authors.affiliation: Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Goldman
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: J N
authors.initials: JN
authors.lastname: Bruce
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: Canoll
keywords: Pineal gland; pleomorphic granular cell astrocytoma; pleomorphic xanthoastrocytoma