Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas.
BACKGROUND
Pineoblastomas are uncommon primitive neuroectodermal tumors that occur mostly in children; they are exceedingly rare in adults. Few published reports have compared the various aspects of these tumors between adults and children.


METHODS
The authors report a series of 12 pineoblastomas in adults from 2 institutions over 24 years. The clinical, radiologic, and pathologic features and clinical outcomes were compared with previously reported cases in children and adults.


RESULTS
Patient age ranged from 24 to 81 years, and all but 1 patient exhibited symptoms of obstructive hydrocephalus. Three patients underwent gross total resection, and subtotal resection was performed in 3 patients. Diagnostic biopsy specimens were obtained in an additional 6 patients. Pathologically, the tumors had the classical morphologic and immunohistochemical features of pineoblastomas. Postoperatively, 10 patients received radiotherapy, and 5 patients received chemotherapy. Compared with previously reported cases, several differences were noted in clinical outcomes. Of the 12 patients, only 5 (42%) died of their disease (average length of survival, 118 months); 5 patients (42%) are alive with no evidence of disease (average length of follow-up, 92 months). One patient died of unrelated causes, and one was lost to follow-up. Patients with subtotal resections or diagnostic biopsies did not suffer a worse prognosis. Of the 9 patients with biopsy or subtotal resection, 4 are alive, 4 died of their disease, and 1 died of an unrelated hemorrhagic cerebral infarction.


CONCLUSIONS
Although this series is small, the data suggest that pineoblastomas in adults have a less aggressive clinical course than in children.
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Melissa A
MA
Gener
Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Andrew R
AR
Conger
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Jamie
J
Van Gompel
Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mohammad S
MS
Ariai
Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Mark
M
Jentoft
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Fredric B
FB
Meyer
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Jeremy S
JS
Cardinal
Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
José M
JM
Bonnin
Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA; Indiana University Simon Cancer Center, Indianapolis, Indiana, USA. Electronic address: acohenmd@gmail.com.
Aaron A
AA
Cohen-Gadol
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000473:pathology / Q000601:surgery; D010871:Pinealoma / Q000473:pathology* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Neoplasms; Outcome; Pathology; Pineoblastoma; Resection