Summary
The authors advocate an aggressive surgical approach to pineal region tumors to provide a definitive histological diagnosis and to facilitate extensive tumor removal. This strategy is based on their surgical experience in 160 operations for pineal region tumors in which operative mortality was 4% with 3% permanent major morbidity. One-third of pineal tumors were benign for which surgery alone was usually curative. A gross total removal was possible in 31 of 107 malignant tumors. The supracerebellar infratentorial approach was preferred in 86% of patients.
The tumors displayed considerable histological diversity with germ cell tumors most common (37%), followd by glial cell tumors (28%) and pineal cell tumors (23%). Mixed tumors occurred 15% of the time. Spinal metastases were rare, occurring in less than 10% of patients with malignant tumors.
These results with a large series of pineal region tumors demonstrate the safety and efficacy of aggressive pineal tumor surgery.
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Bruce, J.N., Stein, B.M. Surgical management of pineal region tumors. Acta neurochir 134, 130–135 (1995). https://doi.org/10.1007/BF01417679
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DOI: https://doi.org/10.1007/BF01417679