Cytogenesis and differentiation of pineal neoplasms

doi:10.1016/S0046-8177(81)80024-X

Human Pathology

Volume 12, Issue 5, May 1981, Pages 441-448

https://doi.org/10.1016/S0046-8177(81)80024-X Get rights and content

Abstract

Our knowledge of pineal neoplasms is still fragmentary, but a pattern is beginning to emerge in this highly challenging area of neuro-oncology. In vitro studies and more complete morphologic and biochemical characterization are still needed for these very rare neoplasms. Follow-up data from appropriate clinical series are still almost nonexistent for the evaluation of therapeutic effectiveness. As an illustration of neoplastic development, the demonstration of divergent differentiation in pineal parenchymal tumors represents a most intriguing phenonemon in light of the origin, structure, and function of the pineal gland.

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Cited by (60)

Pineal cell and germ cell tumors
2011, Brain Tumors: An Encyclopedic Approach, Expert Consult - Online and Print
Pathology of tumors of the pineal region
2008, Revue Neurologique
Tumors of the pineal region are rare and relatively few centers around the world have published substantial numbers of carefully studied cases. This review gives a historical account of our understanding of the normal pineal and the evolution of the classification of tumors and other mass lesions of the pineal region in human beings. Based on our experience over the past 30 years, a working classification is proposed and recent advances in the neuropathology of these lesions are discussed.
Les tumeurs de la région pinéale sont rares, et peu de centres dans le monde ont publié des études bien documentées sur ces cas. Cette revue retrace l’historique de notre connaissance de l’épiphyse normale et de l’évolution de la classification des tumeurs et des autres lésions occupant de l’espace dans cette région. Sur la base de notre expérience des 30 dernières années, nous exposons une classification opérante et discutons les progrès récents dans la neuropathologie de ces lésions.
Nonresective treatment of pineoblastoma: A case report
1995, Surgical Neurology
Tumors of pineal parenchymal cells: A correlation of histological features, including nucleolar organizer regions, with survival in 35 cases
1995, Human Pathology
We studied 35 parenchymal neoplasms arising in the pineal gland, including 11 pineoblastomas, 21 pineocytomas, and three mixed pineocytoma-pineoblastomas. Pineoblastomas were most commonly found in children (mean age, 12.6 years). The median postsurgical length of survival for seven patients, including five with remote metastases, with fatal outcome was 24 months. The 21 pineocytomas were found in older individuals (mean age, 26.8 years). Four patients with pineocytoma died; two before surgery and two in the immediate postoperative period. The remaining 17 patients survived for intervals between 6 and 118 months after surgery. Two mixed pineocytoma-pineoblastomas were found in infants who died a few months after biopsy, whereas a third patient, an adult, was alive at 46 months after excision and irradiation. Both pineoblastoma and pineocytoma exhibited variable immunoreactivity to neurofilament proteins, synaptophysin, glial fibrillary acidic protein, S-100 protein, retinal-S antigen, and rhodopsin; the highest percentages of positive cells stained with synaptophysin. Three pineocytomas exhibited ganglionic differentiation and two of them also showed a glial component. Prognosis could not be correlated with the degree of divergent differentiation. Comparison of silver-stained nucleolar organizer region (AgNOR) counts between pineoblastomas and pineocytomas suggests that the former are more actively proliferative than the latter, with mixed pineocytoma-pineoblastoma showing intermediate activity. There was no correlation between AgNOR score and prognosis within the three tumor groups.
Radiation therapy of pineal region tumors: 25 new cases and a review of 208 previously reported cases
1994, International Journal of Radiation Oncology, Biology, Physics
$Purpose$ : Malignant pineal region tumors are rare neoplasms arising in midline structures of the brain. This report analyzes the influence of histology, tumor location, radiation dose, treatment volume, age and cerebrospinal fluid findings on freedom from relapse, freedom from spinal relapse and survival.
$Methods and Materials$ : Patient and treatment parameters of 25 cases of pineal region tumors managed at Stanford University are presented, and an additional 208 published cases were reviewed. Univariate and multivariate analysis were performed to delineate parameters predictive of freedom from relapse, freedom from spinal relapse, and survival for all 233 patients.
$Results$ : The 5- and 10-year freedom from relapse for Stanford patients was 63% and 46%, respectively. The 5-and 10-year survival for Stanford patients was 67% and 61%, respectively. The 5- and 10-year freedom from relapse for the total 233 cases was 66% and 61%, respectively. The 5- and 10-year survival for all patients was 74% and 68%, respectively. For the entire group, biopsy confirmed germinoma and non-biopsied tumors had superior freedom from relapse compared to non-germinoma germ cell tumors (p = 0.03, p = 0.005, respectively). Non-biopsied patients had improved survival compared to non-germinoma germ cell tumors (p = 0.004). Pineal parenchymal tumors had worse freedom from relapse compared to non-biopsied patients (p = 0.04). For patients with suprasellar tumors, germinomas were associated with improved freedom from relapse compared to non-germinoma germ cell tumors (p = 0.02). Simultaneous pineal and suprasellar tumors had superior survival compared to solitary tumors of pineal (p = 0.04), suprasellar (p = 0.03), or third ventricle location (p = 0.03). Twenty-two patients (9.4%) developed isolated spinal relapse. Five- and 10-year spinal relapse rates for all patients were 11%n and 13%. Survival after spinal relapse was 19%. Pineal parenchymal tumors had lower freedom from spinal relapse compared to non-biopsied patients (p = 0.001). For tumors located in the pineal gland, germinomas and pineal parenchymal tumors had lower freedom from spinal relapse than did non-biopsied patients (p = 0.006, p = 0.004, respectively). Pineal germinomas had lower freedom from spinal relapse than germinomas with suprasellar location (p = 0.04). Univariate and multivariate analysis identified tumor histology as the most significant predictor of freedom from relapse, freedom from spinal relapse and survival.
$Conclusion$ : Histologic type had the greatest impact on outcome. Treatment recommendations should be based on assessment of histologic type and extent of disease.
Pineal Cell and Germ Cell Tumors
2012, Brain Tumors

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^*: Based on the Inaugural Folke Henschen Lecture, given at the Annual Meeting of the Association of Swedish Pathologists, Stockholm, November 30, 1978. Adapted, with permission, from the text published in Läkartidningen (Journal of the Swedish Medical Association).

^†: Professor and Director, Division of Neuropathology, Department of Pathology, University of Virginia Medical Center, Charlottesville, Virginia.

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Cytogenesis and differentiation of pineal neoplasms*

Abstract

The pinealoma: its relationship to teratoma

J. Path. Bact.

Classification of endodermal sinus tumors (mesoblastoma vitellinum) and so-called embryonal carcinoma of the ovary

Acta Path., Microbiol. Scand.

Pineal tumors. A 53-year experience

Arch. Neurol.

Epidemiology of brain tumours

Pathology of brain tumors

Acta Path. Jap.

Suprasellar germinoma

J. Neurosurg.

Endodermal sinus tumor of the pineal region. Case report

Cancer

Primary intracranial endodermal sinus tumor. Case report

J. Neurosurg.

Case report and ultrastructural study of intracranial embryonal carcinoma

Can. J. Neurol. Sci.

Melatonin synthesis by an ectopic pinealoma

New Eng. J. Med.

Immunohistochemical observation of ectopic pinealomas by fluorescent antibody method

Nihon Univ. J. Med.

Alpha-fetoprotein and human chorionic gonadotropin in a patient with a primary intracranial germ cell tumor

Cancer

The cytological differentiating potential of pineal parenchymal neoplasms (true pinealomas). A clinicopathological study of 28 tumours

Brain