Pineal Tumor

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What do I have?

Pineal tumors arise in the region of the pineal gland, a small structure deep within the brain. This gland is thought to be involved in the sleep-wake cycle, though its exact function remains unclear. There are at least 17 different types of tumors that may occur in this region and these tumors range from more aggressive gliomas to benign cysts. The three most common categories of pineal region tumors are gliomas, germ cell tumors (germinomas, embryonal cell carcinoma, teratomas) and pineal cell tumors (pineocytoma and pineoblastoma). Others include meningioma, lymphoma, metastatic tumors, and pineal cysts.

What does it do?

The pineal gland is located deep within the brain near the aqueduct of Sylvius, a passageway through which newly produced cerebrospinal fluid (CSF) travels as it exits the center of the brain. As pineal region tumors grow, they often put pressure on this passage, thus blocking the flow of the CSF. As CSF flow is blocked, pressure builds up in the brain and creates hydrocephalus. Symptoms of hydrocephalus include headache, nausea and vomiting, memory difficulties and imbalance. Severe intracranial (inside the head) pressure may even be life threatening and require immediate attention.

In some cases, a ventriculoperitoneal (VP) shunt be placed in order to alleviate the pressure. During this procedure, a small catheter is placed into the fluid space of the brain and is tunneled under the skin and usually into the empty spaces in the abdomen. The extra fluid that builds up in the head is thus diverted into the belly where it is easily reabsorbed by the body. Another way to alleviate the pressure is through a procedure called a third ventriculostomy. In this procedure, a small hole is made at the base of the brain to allow better flow of the CSF.

Pineal region tumors can also cause abnormalities in vision because they can arise in an area of the brain which controls eye movement. Some symptoms may include inability to focus, double vision, or the inability to move the eyes.

Germ cell tumors of the pineal region can secrete hormones which could lead to disturbances in endocrine function, particularly by causing early puberty in children.

How long have I had it?

This generally depends on the type of tumor present. Pineal cysts may have been present since birth. Other types of pineal region tumors would have developed more recently.

Can it be cured?

Surgery is the first step in the diagnosis and treatment of these tumors. Depending on the size of the tumor, the surgeon may attempt to remove the entire mass or a large portion of it (called a resection) or may just take a small piece (biopsy). The tissue will then be reviewed by a pathologist who will give the diagnosis. The pathology determines the next course of treatment, and in some cases, whether cure is possible. Some less aggressive tumors only require removal while others may require radiation therapy and/or chemotherapy. One common aggressive pineal region tumor, germinoma, can be cured in approximately 90% of cases.

What caused it?

It is not currently known why these tumors develop.

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