Cañizares Méndez María de Los Ángeles, Amosa Delgado Manuel, Álvarez Salgado Juan Antonio, Villaseñor Ledezma Jorge Javier, Capilla Cabezuelo Elena, Díaz Crespo Francisco
Department of Neurosurgery, Complejo Hospitalario de Toledo (CHT), Spain.
Department of Neurosurgery, Complejo Hospitalario de Toledo (CHT), Spain.
Neurocirugia (Engl Ed). 2019 Jan-Feb;30(1):38-43. doi: 10.1016/j.neucir.2018.03.003. Epub 2018 Apr 22.
Papillary tumor of the pineal region is a rare neuroepithelial tumor characterized by papillary architecture and epithelial cytology, immunopositivity for cytokeratin and ependymal differentiation. It is considered grade II-III by the World Health Organization and was first described by Jouvet in 2003. We present a 34-year-old male with headaches, blurred vision and normal examination. Radiological study showed a nodulocystic lesion in the pineal region compatible with pineocytoma. Surgery was performed using an infratentorial supracerebellar approach, finding a cystic tumor in the quadrigeminal cistern which was completely resected. Histopathology reported a papillary tumor of the pineal region. The patient made good progress without adjuvant therapy, and after 57 months of follow-up he remained asymptomatic and free of recurrence. A review of the literature was performed to collect all the cases published with gross total resection and no complementary treatment. In conclusion, there is still much to be learned about the pathogenesis, prognosis and management of this tumor.
松果体区乳头状瘤是一种罕见的神经上皮肿瘤,其特征为乳头状结构、上皮细胞形态、细胞角蛋白免疫阳性及室管膜分化。世界卫生组织将其归为II-III级,于2003年由朱韦首次描述。我们报告一例34岁男性,有头痛、视力模糊症状,体格检查正常。影像学检查显示松果体区有一个与松果体细胞瘤相符的结节状囊性病变。采用幕下小脑上入路进行手术,发现四叠体池有一个囊性肿瘤并将其完全切除。组织病理学报告为松果体区乳头状瘤。患者未接受辅助治疗,恢复良好,随访57个月后仍无症状且无复发。我们对文献进行了回顾,收集了所有行肿瘤全切且未进行辅助治疗的病例。总之,关于该肿瘤的发病机制、预后及治疗仍有许多有待了解之处。