Pineal region pilocytic astrocytoma; an unusual tumor: A cases report

 

Dr. Ashis Kumar Ghosh

Cancer/Oncology specialist

Assistant Professor

Department of Pediatric Hematology and Oncology

National Institute of Cancer Research and Hospital

Expertise: Pediatric Hematology, Pediatric Oncology, Rare Childhood Cancer and Pediatric Medicine

Tel- 01712685509

Pineal region tumors account for <1% of all intracranial neoplasms, of which approximately 14–27% is of pineal parenchymal origin.[1] Gliomas are very rare in the pineal region. They are thought to arise from the native glial cells of pineal gland or from the adjacent structure.[2] A wide spectrum of pineal region glial tumors have been described including pilocytic astrocytoma (PA), pleomorphic xanthoastrocytoma, glioblastoma, oligodendroglioma, and ganglioglioma; mainly as case reports. We report one cases of pineal region PA with variable clinical, radiological, and histological features with a review of literature.

Case 1: An 8-year-old male child was brought to the Pediatric Hematology and Oncology  Department of National Institute of Cancer  with the chief complaints of headache and bilateral diminution of vision for 6 month. Contrast-enhanced magnetic resonance imaging with magnetic resonance spectroscopy revealed a mass in the pineal region measuring 30 mm × 32 mm × 21 mm (mark), showing iso- to hypo-intense signals on T1-weighted and hyperintense signals on T2-weighted images with marked peripheral enhancement (marked) on postcontrast scan [Figure 1]. The spectroscopy from the peripheral part of the lesion shows elevated choline peak (arrow), favoring a malignant lesion, likely pineoblastoma.