Chapter

Pineal Tumor

Tadanori Tomita

in Pediatric Neurosurgery

Published on behalf of Oxford University Press

Published in print January 2019 | ISBN: 9780190617073
Published online January 2019 | e-ISBN: 9780190617103 | DOI: https://dx.doi.org/10.1093/med/9780190617073.003.0019

Series: Neurosurgery by Example

Pineal Tumor

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A diagnosis of pineal region tumor requires a thorough history, physical exam, neuroimaging, and tumor markers. A computed tomography (CT) scan may demonstrate pineal calcification engulfed by the tumor or displaced peripherally. Magnetic resonance imaging (MRI) should be carefully evaluated for contrast enhancement patterns and multifocal disease. Hydrocephalus is common and may be the primary cause of the symptoms at presentation. Cerebrospinal tumor markers need to be performed if the physician suspects germ cell tumor. In children, germ cell tumors are a more common tumor pathology than pineal parenchymal tumors. If tumor markers are nondiagnostic, a histologic biopsy is indicated in order to determine appropriate therapeutic modalities. If surgical resection is indicated, an occipital transtentorial or an infratentorial supracerebellar approach may be used, depending on the tumor anatomy and surgeon preference.

Chapter.  3331 words.  Illustrated.

Subjects: Paediatrics ; Neurosurgery

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