The pineal gland is a small gland, situated near the brain center, between the two hemispheres of the brain.
It is an extremely important gland for the functioning of the human body. Unlike most intracranial structures, the gland is not protected by the blood-brain barrier. The pineal gland is triggered by light and it controls a variety of bio-rhythms of the body. It also secretes melatonin, a powerful regulator of wake/sleep, seasonal functions and activity of gonadotrophic and other endocrine hormones.
It consists of cells, the pineocytes and tumours can arise from these cells as also from other cells of the pineal region. Pineal tumours are responsible for 1% of all brain tumours.
What are pineal tumours ?
Pineal region tumours are derived from cells located in and around the pineal gland. The principle cell of the pineal gland is the pineal parenchymal cell or the pineocyte. This cell is a specialized neuron related to retinal rods and cones. True pineal cell tumours differ from other brain tumours.
What are the causes of pineal tumours ?
Tumours of the pineal region can broadly be divided into either germ cell or non-germ cell derivatives. Most pineal tumours can be either due to malignant change in misplaced embryonic tissue, the pineal parenchymal cells, or in the surrounding astrocytes.
What are the types of pineal tumours ?
There are several types of cancer that can initiate in the pineal gland.The tumour can be either a germ cell tumour (germinoma and nongerminomatous germ cell tumours), an embryonal pineoblastoma, the mature pineocytoma, or tumours exhibiting a mix of the above types. There also could be metastasis and tumours from invasion of the gland by adjacent tumours.
What are the clinical features of pineal tumours ?
It can affect either children or adults. A tumour in the pineal gland can be asymptomatic or cause non-specific (headache and seizures), endocrine disturbances and mass-related manifestations. Pineal tumours can build up pressure in skull and cause intracranial pressure to increase. This is either because of increased growth of the tumour, brain swelling, or cerebrospinal fluid blockage (CSF). Increased pressure can also cause headache, nausea, vomiting, blurred vision and balance problems.
How are pineal tumours diagnosed ?
- A complete physical examination of the body is mandatory.
- Imaging Tests: Important diagnostic tests include the following such as CT Scan, MRI Scan or PET Scans. Magnetic Resonance Imaging (MRI) & Computed Tomography (CT) Scans are the imaging tests used most often for diagnosis of pineal tumours. Cross-sectional imaging, particularly MRI, is vital for pineal masses. Simple, benign, uncomplicated pineal cysts do not require further imaging. However, if there is an enhancing pineal mass, it is important to image the entire brain, as these aggressive tumours are prone to CSF dissemination.
Magnetic resonance angiography (MRA): This specialized MRI is done to analyze the blood vessels in the brain. This is extremely useful before surgery to help the surgeon plan operations. - Biopsy : Removed tissue examined under a microscope by a pathologist is the only sure-shot way to make a definitive cancer diagnosis. Pineal tumour biopsy may be done either as a stand-alone procedure, or it may be part of the main surgery to remove tumour. It could be either a stereotactic (needle) biopsy or surgical and open biopsy (craniotomy).
How are pineal tumours staged & graded ?
Grade and Stage describe the Pineal Tumour, helping to provide guidance for the oncologist in choosing the best treatment option(s). Staging is a careful attempt to find out the exact extent and spread of the cancer. The higher the stage the further the cancer has grown away from its original site in the brain.
Doctors classify brain tumours by grade. Grade refers to what the cancer cells look like, and how much they resemble their cell of origin or differentiation. The higher the grade, the more aggressive the tumour is.
How are pineal tumours treated ?
Treatment options depend on the type of Pineal Tumour, staging of the tumour, and its location. A neurosurgeon will have to be consulted, and either a single therapy or a combination of treatments will be decided for you by a multi-disciplinary panel of oncosurgeons, radiologists and your general physician.
There are four treatments for Pineal Tumours.
- Surgery : Surgical treatments for pineal tumours include stereotactic surgery making the tumours of pineal region more accessible and amenable to treatment.
- Radiation Therapy : Advanced radiologic treatment that utilizes high-energy x-rays or basically radiation to eradicate cancer cells. Radiation can be used on select patients if surgery is not a good option. Radiation therapy can also be used post surgery to kill any remaining cancer cells. Craniospinal irradiation is indicated if there are signs of CSF dissemination.
- Chemotherapy : Another kind of cancer treatment that uses either drugs or chemical substances (hence the name chemotherapy) to kill cancer cells and prevent them from dividing.
What is the care to be taken after pineal tumour surgery ?
Metastatic diagnostic workup and monitoring post-treatment has to include imaging and scanning of the brain and spinal cord with radiography, MRI or CT scans because of the risk of possible recurrences.
Adjuvant chemotherapy or radiotherapy may be required in cases wherein excision cannot be done completely. Hormonal replacement therapy might also be required in certain cases, of endocrine disturbances.
How to find and reach neurosurgeons for pineal tumour surgery ?
Now you can find and reach neurosurgeons for pineal tumour surgery from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple neurosurgeons, get cost estimates for pineal tumour surgery from different hospitals, compare things and then choose an neurosurgeon or a hospital for pineal tumour surgery.
Find, reach and choose an neurosurgeon for pineal tumour surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
