Surgical treatment of a rare rosette-forming glioneuronal tumor in the pineal region.

Operative nuances Pineal region Rosette-forming glioneuronal tumor

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2020
Historique:
received: 08 05 2019
accepted: 17 03 2020
entrez: 5 5 2020
pubmed: 5 5 2020
medline: 5 5 2020
Statut: epublish

Résumé

Rosette-forming glioneuronal tumors (RGNTs) in the pineal region are rare. RGNTs have been described in the fourth ventricle, but rarely reported in other brain regions. Here, we report the radiological findings, surgical treatment, and short-term outcome of an RGNT found in the pineal region. We present a case of a 22-year-old medical student with a 4-month history of headaches and diplopia. A previous magnetic resonance imaging scan revealed a mass in the pineal region, with heterogeneous contrast enhancement and hydrocephalus. Three months prior, an endoscopic biopsy and third ventriculocisternostomy were performed elsewhere; the diagnosis was neurocytoma Grade I, and radiotherapy was planned. The patient presented at our hospital for a second opinion, and we suggested surgical treatment. A near-total resection was performed in sitting position using a supracerebellar infratentorial microsurgical approach. The tumor was very soft and not well vascularized. Diplopia was initially worsened after the tumor was removed and relieved completely after 2 weeks. An 8-week follow-up examination revealed that the patient was free of symptoms. Histological analysis confirmed it was an RGNT. Maximal safe resection in pineal region RGNTs is a feasible and recommended treatment option.

Sections du résumé

BACKGROUND BACKGROUND
Rosette-forming glioneuronal tumors (RGNTs) in the pineal region are rare. RGNTs have been described in the fourth ventricle, but rarely reported in other brain regions. Here, we report the radiological findings, surgical treatment, and short-term outcome of an RGNT found in the pineal region.
CASE DESCRIPTION METHODS
We present a case of a 22-year-old medical student with a 4-month history of headaches and diplopia. A previous magnetic resonance imaging scan revealed a mass in the pineal region, with heterogeneous contrast enhancement and hydrocephalus. Three months prior, an endoscopic biopsy and third ventriculocisternostomy were performed elsewhere; the diagnosis was neurocytoma Grade I, and radiotherapy was planned. The patient presented at our hospital for a second opinion, and we suggested surgical treatment. A near-total resection was performed in sitting position using a supracerebellar infratentorial microsurgical approach. The tumor was very soft and not well vascularized. Diplopia was initially worsened after the tumor was removed and relieved completely after 2 weeks. An 8-week follow-up examination revealed that the patient was free of symptoms. Histological analysis confirmed it was an RGNT.
CONCLUSION CONCLUSIONS
Maximal safe resection in pineal region RGNTs is a feasible and recommended treatment option.

Identifiants

pubmed: 32363063
doi: 10.25259/SNI_294_2019
pii: SNI-11-68
pmc: PMC7193215
doi:

Types de publication

Case Reports

Langues

eng

Pagination

68

Informations de copyright

Copyright: © 2020 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

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Auteurs

Sajjad Muhammad (S)

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Neurosurgery, Heinrich-Heine University Medical Center, Düsseldorf, Germany.

Ahmad Hafez (A)

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Atte Karppinen (A)

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Mika Niemelä (M)

Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Classifications MeSH