1/36. The role of chemotherapy in intracranial germinoma: a case report.BACKGROUND: The case of a 29-year-old man with histologically proven simultaneous germinoma (seminoma) of the pineal gland and a stage I embryonal carcinoma of the testis is reported. An intradural metastatic lesion from the pineal germinoma was diagnosed at the level of the first thoracic vertebra. Treatment, after inguinal orchiectomy, was chemotherapy only, rather than conventional radiotherapy for the pineal germinoma. methods: Therapy consisted of bleomycin (B), etoposide (E) and cisplatin (P). MRI was used to assess the effectiveness of BEP chemotherapy. RESULTS: A complete remission of the pineal gland germinoma and the epidural metastasis was documented after two cycles of BEP chemotherapy and after 15 months of follow-up the patient remains free of relapse. DISCUSSION: The pathogenesis of simultaneously occurring germinoma of the pineal gland and embryonal cell carcinoma of the testis is discussed. The choice of therapy in these circumstances is a matter of debate and the good result of chemotherapy alone in this patient suggest that primary chemotherapy may be the therapy of choice in patients with pineal germinomas.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/36. Clinics in diagnostic imaging (37). germinoma of the pineal gland.Tumours occurring in the region of the pineal gland are uncommon in paediatric patients but may manifest with typical signs and symptoms. A 6-year-old boy with precocious puberty caused by a germinoma of the pineal gland detected on skull radiographs and confirmed on MR imaging is reported. The different types of tumours occurring in the region of the pineal gland and their imaging findings are discussed.- - - - - - - - - - ranking = 2.3333333333333keywords = gland (Clic here for more details about this article) |
3/36. Successful pregnancy by intracytoplasmic sperm injection after radiotherapy-induced azoospermia.A 27-year-old male, who underwent excision and radiotherapy for a pineal gland germinoma four years previously, subsequently developed panhypopituitarism and, thus, complete azoospermia. Gonadotrophin replacement therapy resulted in the production of a small number of motile spermatozoa which were used for Intracytoplasmic Sperm Injection (ICSI) into oocytes obtained from his wife. After successful fertilization and embryo transfer, a singleton intrauterine pregnancy was achieved which resulted in the normal delivery of a morphologically normal male live infant at term.- - - - - - - - - - ranking = 0.33333333333333keywords = gland (Clic here for more details about this article) |
4/36. Primary pineal melanocytic tumor. Case report.A primary melanocytic lesion arising from the pineal gland is very rare. The authors report a case of primary pineal melanocytic tumor with dissemination to the right hippocampus in a 50-year-old woman who presented with memory disturbance. Magnetic resonance (MR) imaging revealed a mass that was hyperintense on T1-weighted and hypointense on T2-weighted MR images. The pineal tumor was removed subtotally via the occipital transtentorial approach, and the patient underwent whole-brain irradiation. Results of histological examination revealed that the tumor predominantly consisted of atypical cells with scanty melanin pigment and some necrotic foci. The strongly pigmented areas of the tumor contained well-differentiated cells similar to those of melanocytoma. An ultrastructural study demonstrated evidence of a mature type of melanosome. The patient died 11 months after surgery and radiotherapy (1.7 years after the onset of symptoms). The autopsy findings demonstrated tumor invasion into the parenchyma through the leptomeningeal space and the ventricular wall. The tumor was diagnosed as being malignant, and it was finally concluded that the atypical cells in the tumor were probably responsible. This pineal melanocytic tumor exhibited a wide spectrum of differentiation, ranging from highly malignant melanoma to well-differentiated melanocytoma, which may have contributed to the patient's relatively long survival period. The biological behavior and morphological characteristics of this tumor appear to be similar to those of other pineal parenchymal lesions.- - - - - - - - - - ranking = 0.33333333333333keywords = gland (Clic here for more details about this article) |
5/36. Dorsal midbrain syndrome secondary to a pineocytoma.BACKGROUND: Dorsal midbrain syndrome is a triad of signs consisting of vertical gaze palsy, light-near dissociation of the pupils, and convergence retraction nystagmus. Associated findings may also be present. The most-common etiologies are pineal gland tumors and midbrain infarction. pineal gland tumors are rare tumors that show a predilection for males. The specific tumor reported herein, a pineocytoma, shows no gender predilection and is most common in mid- to late adulthood. CASE REPORT: A 38-year-old Native American man came to us with signs and symptoms consistent with dorsal midbrain syndrome. A neurological evaluation revealed the presence of a pineocytoma, which was later excised unsuccessfully. An explanation of the findings associated with dorsal midbrain syndrome is provided. CONCLUSION: patients who demonstrate signs consistent with dorsal midbrain syndrome should be referred for a neurological evaluation--including an MRI--to rule out any midbrain lesion.- - - - - - - - - - ranking = 0.66666666666667keywords = gland (Clic here for more details about this article) |
6/36. histiocytosis mimicking a pineal gland tumour.We report an unusual case of isolated Langerhans cell histiocytosis of the central nervous system. A 19-year-old man presented with an incomplete ocular palsy. MRI revealed a solitary mass in the pineal gland with marked contrast enhancement. Complete microsurgical excision was followed by local radiotherapy. Histological examination revealed histiocytosis. Unifocal brain involvement by histiocytosis X is rare with few cases in the literature; the most commonly involved areas are the hypothalamus and the pituitary gland.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
7/36. Melanotic neuroectodermal tumour of the pineal region.We describe CT and MR findings in a 23-month-old infant with a melanotic neuroectodermal tumour of the pineal gland. The tumour has been stereotactically biopsied and surgically resected. The pathological diagnosis was made on the resected piece. embryology of the pineal gland and the histology of melanotic neuroectodermal tumour of infancy are discussed.- - - - - - - - - - ranking = 0.66666666666667keywords = gland (Clic here for more details about this article) |
8/36. Atypical pleomorphic astrocytoma in the pineal gland: case report.OBJECTIVE AND IMPORTANCE: We report a rare case of pleomorphic astrocytoma in the pineal region that took a benign course despite pleomorphism. CLINICAL PRESENTATION: A 30-year-old woman suddenly developed right hemiparesis followed by loss of consciousness. A computed tomographic scan revealed a mass in the pineal region accompanied by obstructive hydrocephalus. Her symptoms improved after ventriculoperitoneal shunt surgery. INTERVENTION: The tumor was totally removed in an en bloc fashion using the occipital interhemispheric transtentorial route. light microscopy revealed that the tumor had marked pleomorphism and multinucleated, bizarre giant cells, but neither mitosis nor necrosis was seen. Glial fibrillary acid protein was immunohistochemically positive in a few tumor cells. Retinal soluble antigen was negative. No reticulin network between the tumor cells was observed. A histological diagnosis of atypical pleomorphic astrocytoma was made. CONCLUSION: No signs of recurrence have been observed for 7 years after surgery without adjuvant therapy. Histologically, the tumor resembled pleomorphic xanthoastrocytoma or pleomorphic granular cell astrocytoma, but the immunohistochemical findings were not completely compatible with either diagnosis. This benign astrocytoma in the pineal gland with unique features is the first such case reported.- - - - - - - - - - ranking = 1.6666666666667keywords = gland (Clic here for more details about this article) |
9/36. Successful treatment of extracranially metastasized pineal gland germinoma with high-dose methotrexate.germinoma of the pineal gland is a rare disease usually confined to the brain which responds well to radiotherapy. Spinal seeding occurs in approximately 4% of cases and distant metastases are extremely rare. We report on a 27-year-old female with an intracranially metastasized pineal gland germinoma, meningeal carcinomatosis and distant bone metastases. Treatment was initiated with intrathecal methotrexate (MTX) and continued with high-dose intravenous MTX. The therapy was very well tolerated apart from reversible hepatic toxicity requiring a dose reduction. The patient was in complete remission after three courses followed by two consolidation cycles; the patient has now been in continuous complete remission for more than 22 months. This is the first report to show that MTX is a potent drug in treating pineal gland germinoma. Long-term side effects of radiotherapy such as reduced mental function or hypopituitarism can probably be avoided. Single-agent high-dose MTX may provide high efficacy with limited adverse effects, especially at a more advanced tumor stage with spinal seeding and extracranial disease.- - - - - - - - - - ranking = 2.3333333333333keywords = gland (Clic here for more details about this article) |
10/36. Unique pineal gland metastasis of clear cell renal carcinoma: case report and review of the literature.The metastatic involvement of the pineal gland is an extremely unusual event; it has a 4% incidence in patients with disseminated neoplasias. Most metastatic pineal lesions are asymptomatic. Only in a small number of cases the symptoms produced by metastatic involvement of this organ precede those of the primary tumor or those of another metastatic site. To our knowledge the herein reported case is the first in which the pineal gland was apparently the unique metastatic site of a primitive kidney carcinoma and where the symptoms produced by metastasis in the pineal region were the first sign of the disease.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
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