The Common vein Copyright 2010
A pineocytoma is a slow growing neoplasm which arises from the pineal gland. These low grade neoplasms are generally found in adults. These tumors are generally confined to pineal gland but are unencapsulated.
Pathologically these tumors are made up of well differentiated cells which have a very similar appearance to normal pineal cells. They are cells with round small nuclei which are well differentiated with neuronal features. There are no aggressive pathologic features such as mitoses or necrosis.
Clinically patients present between the age of 10-20 with signs of hydrocephalus due to obstruction at the Sylvian aqueduct or from Paerinaud’s syndrome which is a vertical gaze palsy.
On imaging, these tumors are generally small, measuring less than 3cm. MRI is better for characterization of these lesions. They are generally homogeneous and demonstrate uniform enhancement, often indistinguishable from germinomas especially when in a male patient. They can however also often contain either cystic components or calcifications. When seen, these calcifications are generally peripheral with an “exploded” appearance, as opposed to the pattern of calcifications seen in germinomas.
Treatment for pineocytoma includes surgery and possible radiation.
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