Contemporary management of pineocytoma

Contemporary Management of Pineocytoma Aaron J. Clark, MD, PhDa, Michael E. Sughrue, MDb, Derick Aranda, MDa, Andrew T. Parsa, MD, PhDa,* KEYWORDS  Pineocytoma  Surgery  Radiotherapy  Gross total resection  Tumor control  Overall survival

SURGICAL DEBULKING IMPROVES TUMOR CONTROL AND SURVIVAL The pineal region harbors tumors of diverse pathology, and therefore obtaining a definitive tissue diagnosis is the initial goal of surgery.69 Open biopsy in generally preferred relative to stereotactic biopsy for tumors in this location.70 Because of the unique location of the pineal gland with respect to the vein of Galen as it receives the

basal vein of Rosenthal, the internal cerebral, and the inferior occipital veins, the benefits of any open surgical procedure in this area must be weighted against risk to these critical deep venous structures.71,72 These structures will be encountered regardless of approach selection. The authors showed that, in the setting of pineocytoma, surgical resection reduced the overall reported rate of progression compared with biopsy (6.3% vs 17.8%; c2 P