Metastasizing pineal germinoma. A case report and review.

A patient with biopsy-proven pineal germinoma was treated successfully by craniospinal irradiation. Lung and hilar node metastases developed 22 months after therapy. These were subtotally resected and further cis-platinum, vinblastine and bleomycin chemotherapy given with control 8 months later. Twenty cases of metastases from pineal tumours are documented. The role of chemotherapy as adjuvant therapy, and in recurrent and metastatic disease is reviewed.