[Pineal region tumors in children: is gross-total resection necessary? A single-center experience].
BACKGROUND
Survival of children with pineal region tumors has increased significantly in the last decade; these tumors have an insidious outcome associated with endocrine disorders with high morbidity and mortality, especially after gross resection. The objective was to report the survival, outcome, morbidity and mortality according to type of surgery, histology and treatment in children with pineal region tumors.


METHODS
This retrospective study included all patients of 17 years or less with diagnosis of pineal region tumor, who went over a period of 10 years to a children's hospital. A histopathological review was made, and the extent of resection was determined. The survival was also estimated.


RESULTS
Forty-six patients were included, out of which 36 had complete medical records and adequate pathologic material. Gross resection was performed in 24 (66.6 %), and biopsy in 12 (33.3 %); 23 (88 %) patients died; hydroelectrolytic imbalance was the cause of 14 deaths (60 %) and the other nine (39.1 %) were secondary to tumor progression. Ten-years survivals among patients treated with gross resection and biopsy were 52 and 75 %, respectively (p = 0.7). Endocrine alterations were observed in 13 patients (36.1 %); in 10 of these (76.9 %) the total resection was performed.


CONCLUSIONS
Pineal region tumors in children can be treated with diagnostic biopsy, followed by adjuvant treatment consisting of chemotherapy and radiotherapy.
Jefatura de Servicio de Oncología, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México. elopezaguilar@hotmail.com.
Enrique
E
López-Aguilar
María del Carmen
Mdel C
Garza-González
Mariana
M
Ortiz-Azpilcueta
Ana Carolina
AC
Sepúlveda-Vildósola
Ana
A
Rioscovian-Soto
Hermilo
H
de la Cruz-Yañez
Yadira
Y
Betanzos-Cabrera
D000293:Adolescent; D001254:Astrocytoma / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018237:Germinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D010870:Pineal Gland / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
Neuroendocrine tumors; Pineal neoplasms