Pineal cysts in children: a paediatric series treated over the last twenty years in Lyon.
Benign
Paediatric
Pineal
Surgery
Journal
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
ISSN: 1433-0350
Titre abrégé: Childs Nerv Syst
Pays: Germany
ID NLM: 8503227
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
31
08
2023
accepted:
10
10
2023
medline:
29
11
2023
pubmed:
29
10
2023
entrez:
29
10
2023
Statut:
ppublish
Résumé
Pineal cysts are a rare lesion of the pineal gland. Pineal cysts are benign lesions, generally asymptomatic, and are usually an incidental discovery on MRI performed for other problems. The management of pineal cysts in children remains a matter for debate. Here, we report our own retrospective paediatric cases that have been surgically treated and review the paediatric literature on this topic. This is a retrospective monocentric study. All patients operated by the senior author (CM) for a benign pineal cyst from 2000 to 2021 were included. All other pineal region cystic lesions were excluded. Medical and surgical data were extracted from the hospital medical database. Twelve patients were included. The clinical symptomatology was characterized by headaches in seven patients, visual troubles in two patients, precocious puberty in one patient, signs of intracranial hypertension in two patients, seizures associated with headache in one patient, and headaches associated with behavioural troubles in another patient. No major post-operative complications were observed in this series. It is to noted that surgery was performed because a suspicion of a true pineal parenchymal tumour has been made. Histopathological study came back with the diagnosis of pineal cyst. Pineal cyst is rare. If the radiological diagnosis is clear, no surgery is advocated except in cases associated with hydrocephalus and rapid growth. In case of a suspicion of a true pineal parenchymal tumour, a surgery may be needed to confirm the diagnosis. Lastly, we stress that only cystic lesions of the pineal gland itself should be considered as pineal cyst.
Sections du résumé
BACKGROUND
BACKGROUND
Pineal cysts are a rare lesion of the pineal gland. Pineal cysts are benign lesions, generally asymptomatic, and are usually an incidental discovery on MRI performed for other problems. The management of pineal cysts in children remains a matter for debate. Here, we report our own retrospective paediatric cases that have been surgically treated and review the paediatric literature on this topic.
METHODS
METHODS
This is a retrospective monocentric study. All patients operated by the senior author (CM) for a benign pineal cyst from 2000 to 2021 were included. All other pineal region cystic lesions were excluded. Medical and surgical data were extracted from the hospital medical database.
RESULTS
RESULTS
Twelve patients were included. The clinical symptomatology was characterized by headaches in seven patients, visual troubles in two patients, precocious puberty in one patient, signs of intracranial hypertension in two patients, seizures associated with headache in one patient, and headaches associated with behavioural troubles in another patient. No major post-operative complications were observed in this series. It is to noted that surgery was performed because a suspicion of a true pineal parenchymal tumour has been made. Histopathological study came back with the diagnosis of pineal cyst.
CONCLUSIONS
CONCLUSIONS
Pineal cyst is rare. If the radiological diagnosis is clear, no surgery is advocated except in cases associated with hydrocephalus and rapid growth. In case of a suspicion of a true pineal parenchymal tumour, a surgery may be needed to confirm the diagnosis. Lastly, we stress that only cystic lesions of the pineal gland itself should be considered as pineal cyst.
Identifiants
pubmed: 37898987
doi: 10.1007/s00381-023-06181-y
pii: 10.1007/s00381-023-06181-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3467-3474Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Mottolese C, Beuriat PA, Szathmari A (2015) Pineal tumours: experience of the French National Register and the Lyon School, results and considerations. Neurochirurgie 61:223–235. https://doi.org/10.1016/j.neuchi.2014.02.006
doi: 10.1016/j.neuchi.2014.02.006
pubmed: 24933478
Al-Holou WN, Garton HJL, Muraszko KM et al (2009) Prevalence of pineal cysts in children and young adults. Clinical article J Neurosurg Pediatr 4:230–236. https://doi.org/10.3171/2009.4.PEDS0951
doi: 10.3171/2009.4.PEDS0951
pubmed: 19772406
Taraszewska A, Matyja E, Koszewski W et al (2008) Asymptomatic and symptomatic glial cysts of the pineal gland. Folia Neuropathol 46:186–195
pubmed: 18825594
Campbell A (1899) Notes of two cases of dilatation of central cavity or ventricle of pineal gland. Tr Path Soc 50:15–17
Puusepp L (1914) Die operative Entfernung einer Zyste der Glandula pinealis. Neurol Centralbl 560–563
Berhouma M, Ni H, Delabar V et al (2015) Update on the management of pineal cysts: case series and a review of the literature. Neurochirurgie 61:201–207. https://doi.org/10.1016/j.neuchi.2013.08.010
doi: 10.1016/j.neuchi.2013.08.010
pubmed: 24907165
Mamourian A, Towfighi J (1994) MR of pineal cysts. AJNR Am J Neuroradiol 15:1796–1797
pubmed: 7847232
pmcid: 8333735
Gokce E, Beyhan M (2018) Evaluation of pineal cysts with magnetic resonance imaging. World J Radiol 10:65–77. https://doi.org/10.4329/wjr.v10.i7.65
doi: 10.4329/wjr.v10.i7.65
pubmed: 30079153
pmcid: 6068724
Di Costanzo A, Tedeschi G, Di Salle F et al (1993) Pineal cysts: an incidental MRI finding? J Neurol Neurosurg Psychiatry 56:207–208. https://doi.org/10.1136/jnnp.56.2.207
doi: 10.1136/jnnp.56.2.207
pubmed: 8437012
pmcid: 1014825
Sawamura Y, Ikeda J, Ozawa M et al (1995) Magnetic resonance images reveal a high incidence of asymptomatic pineal cysts in young women. Neurosurgery 37:11–15; discussion 15–16. https://doi.org/10.1227/00006123-199507000-00002
Pu Y, Mahankali S, Hou J et al (2007) High prevalence of pineal cysts in healthy adults demonstrated by high-resolution, noncontrast brain MR imaging. AJNR Am J Neuroradiol 28:1706–1709. https://doi.org/10.3174/ajnr.A0656
doi: 10.3174/ajnr.A0656
pubmed: 17885233
pmcid: 8134222
Lee DH, Norman D, Newton TH (1987) MR imaging of pineal cysts. J Comput Assist Tomogr 11:586–590. https://doi.org/10.1097/00004728-198707000-00005
doi: 10.1097/00004728-198707000-00005
pubmed: 3597879
Golzarian J, Balériaux D, Bank WO et al (1993) Pineal cyst: normal or pathological? Neuroradiology 35:251–253. https://doi.org/10.1007/BF00602604
doi: 10.1007/BF00602604
pubmed: 8492885
Carr J (1944) Cystic hydrops of the pineal gland with a report of 6 cases. J Nerv Ment Dys 552–572
Kappers J (1962) Diencephalon. In: Correlative anatomy of the nervous system, Crosby EC, Humphrey T, Lauer EW (eds). New York, pp 268–271
Tapp E, Huxley M (1972) The histological appearance of the human pineal gland from puberty to old age. J Pathol 108:137–144. https://doi.org/10.1002/path.1711080207
doi: 10.1002/path.1711080207
pubmed: 4647506
Hasegawa A, Ohtsubo K, Mori W (1987) Pineal gland in old age; quantitative and qualitative morphological study of 168 human autopsy cases. Brain Res 409:343–349. https://doi.org/10.1016/0006-8993(87)90720-7
doi: 10.1016/0006-8993(87)90720-7
pubmed: 3580881
Fain JS, Tomlinson FH, Scheithauer BW et al (1994) Symptomatic glial cysts of the pineal gland. J Neurosurg 80:454–460. https://doi.org/10.3171/jns.1994.80.3.0454
doi: 10.3171/jns.1994.80.3.0454
pubmed: 8113858
Kappers JA (1969) The mammalian pineal organ. J Neurovisc Relat 31(Suppl 9):140+. https://doi.org/10.1007/978-3-662-25519-3_7
Klein P, Rubinstein LJ (1989) Benign symptomatic glial cysts of the pineal gland: a report of seven cases and review of the literature. J Neurol Neurosurg Psychiatry 52:991–995. https://doi.org/10.1136/jnnp.52.8.991
doi: 10.1136/jnnp.52.8.991
pubmed: 2677249
pmcid: 1031840
Wisoff JH, Epstein F (1992) Surgical management of symptomatic pineal cysts. J Neurosurg 77:896–900. https://doi.org/10.3171/jns.1992.77.6.0896
doi: 10.3171/jns.1992.77.6.0896
pubmed: 1432132
Tamaki N, Shirataki K, Lin TK et al (1989) Cysts of the pineal gland. A new clinical entity to be distinguished from tumors of the pineal region. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg 5:172–176. https://doi.org/10.1007/BF00272122
doi: 10.1007/BF00272122
Hirato J, Nakazato Y (2001) Pathology of pineal region tumors. J Neurooncol 54:239–249
doi: 10.1023/A:1012721723387
pubmed: 11767290
Fleege MA, Miller GM, Fletcher GP et al (1994) Benign glial cysts of the pineal gland: unusual imaging characteristics with histologic correlation. AJNR Am J Neuroradiol 15:161–166
pubmed: 8141049
pmcid: 8332082
Mena H, Armonda RA, Ribas JL et al (1997) Nonneoplastic pineal cysts: a clinicopathologic study of twenty-one cases. Ann Diagn Pathol 1:11–18
doi: 10.1016/S1092-9134(97)80004-4
pubmed: 9869821
Goehner D, Soyland D, Vuong S, Trumble E (2020) Pineal cyst apoplexy in an 8-year-old girl: case report and literature review. World Neurosurg 142:159–166. https://doi.org/10.1016/j.wneu.2020.06.199
doi: 10.1016/j.wneu.2020.06.199
pubmed: 32615292
Jouvet A, Fèvre-Montange M, Besançon R et al (1994) Structural and ultrastructural characteristics of human pineal gland, and pineal parenchymal tumors. Acta Neuropathol (Berl) 88:334–348
doi: 10.1007/BF00310377
pubmed: 7839826
Pfaff E, Aichmüller C, Sill M et al (2020) Molecular subgrouping of primary pineal parenchymal tumors reveals distinct subtypes correlated with clinical parameters and genetic alterations. Acta Neuropathol (Berl) 139:243–257. https://doi.org/10.1007/s00401-019-02101-0
doi: 10.1007/s00401-019-02101-0
pubmed: 31768671
Choque-Velasquez J, Colasanti R, Baluszek S et al (2020) Systematic review of pineal cysts surgery in pediatric patients. Childs Nerv Syst 36:2927–2938. https://doi.org/10.1007/s00381-020-04792-3
doi: 10.1007/s00381-020-04792-3
pubmed: 32691194
pmcid: 7649165
Mandera M, Marcol W, Bierzyńska-Macyszyn G, Kluczewska E (2003) Pineal cysts in childhood. Childs Nerv Syst ChNS Off J Int Soc Pediatr Neurosurg 19:750–755. https://doi.org/10.1007/s00381-003-0813-2
doi: 10.1007/s00381-003-0813-2
McNeely PD, Howes WJ, Mehta V (2003) Pineal apoplexy: is it a facilitator for the development of pineal cysts? Can J Neurol Sci J Can Sci Neurol 30:67–71. https://doi.org/10.1017/s031716710000247x
doi: 10.1017/s031716710000247x
Radovanovic I, Dizdarevic K, de Tribolet N et al (2009) Pineal region tumors–neurosurgical review. Med Arh 63:171–173
pubmed: 20088167
Michielsen G, Benoit Y, Baert E et al (2002) Symptomatic pineal cysts: clinical manifestations and management. Acta Neurochir (Wien) 144:233–242; discussion 242. https://doi.org/10.1007/s007010200031
Konovalov AN, Pitskhelauri DI (2003) Principles of treatment of the pineal region tumors. Surg Neurol 59:250–268
doi: 10.1016/S0090-3019(03)00080-6
pubmed: 12748006
Hayashi N, Murai H, Ishihara S et al (2011) Nationwide investigation of the current status of therapeutic neuroendoscopy for ventricular and paraventricular tumors in Japan. J Neurosurg 115:1147–1157. https://doi.org/10.3171/2011.7.JNS101976
doi: 10.3171/2011.7.JNS101976
pubmed: 21838511
Macarthur DC, Buxton N, Punt J et al (2002) The role of neuroendoscopy in the management of brain tumours. Br J Neurosurg 16:465–470. https://doi.org/10.1080/0268869021000030276
doi: 10.1080/0268869021000030276
pubmed: 12498490
Husain M, Jha D, Thaman D et al (2004) Ventriculostomy in a tumor involving the third ventricular floor. Neurosurg Rev 27:70–72. https://doi.org/10.1007/s10143-003-0273-x
doi: 10.1007/s10143-003-0273-x
pubmed: 12905077
Chibbaro S, Di Rocco F, Makiese O et al (2012) Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance. Neurosurg Rev 35:331–338; discussion 338–340. https://doi.org/10.1007/s10143-011-0370-1
Hanna B, Robinson MW, Skoch J (2022) Exclusively endoscopic management of complicated pineal cysts in young children: definitive treatment through single burr-hole technique. Surg Neurol Int 13:281. https://doi.org/10.25259/SNI_302_2022
Mottolese C, Szathmari A, Ricci-Franchi AC et al (2015) Supracerebellar infratentorial approach for pineal region tumors: our surgical and technical considerations. Neurochirurgie 61:176–183. https://doi.org/10.1016/j.neuchi.2014.02.004
doi: 10.1016/j.neuchi.2014.02.004
pubmed: 24863689