The Common Vein Copyright 2010
A pineoblastoma is the more aggressive counterpart to a pineocytoma. These are more commonly found in children within the first decade of life. There is an association between pineoblastomas and inherited retinoblastomas.
Pineoblastomas can result in CSF seeding of tumor cells.
Clinically patients present with similar symptoms to other patients with pineal region masses with symptoms including those of hydrocephalus including headache, nausea and vomiting or palsy of vertical gaze.
Pathologic evaluation demonstrates high-grade lesions which are less differentiated compared to pineocytomas. They are made up of densely packed tumor cells with other aggressive features including mitoses and necrosis.
On imaging these tumors can be hyperdense on CT due to their densely packed cellular nature. When calcifications are seen, they are generally in a pattern of an “exploded” pineal gland, or more peripheral than the pattern of central calcifications seen in germinomas. These tumors generally demonstrate avid enhancement.
Treatment for pineoblastomas includes combinations of surgery, radiation and chemotherapy.
J G Smirniotopoulos, E J Rushing, and H Mena. Pineal region masses: differential diagnosis. Radiographics May 1992 12:577-596
Moschovi M and Chrousis GP. Pineal gland masses. UpToDate Updated December 2009.