Bechri Hajar, Oudrhiri Mohammed Yassaad, Louraoui Sidi Mamoun, Melhaoui Adyl, Sefiani Sanae, Arkha Yasser, El Ouahabi Abdessamad
Department of Neurosurgery, Hôpital des Spécialités, Rue Lamfadel Cherkaoui Rabat Institut, Rabat, Morocco.
Department of Neurosurgery, Cheikh Khalifa Hospital, Ave Mohamed Taieb Naciri, Casablanca, Morocco.
Surg Neurol Int. 2021 Aug 3;12:386. doi: 10.25259/SNI_613_2020. eCollection 2021.
Papillary tumors of the pineal region are rare neuroepithelial lesions that were described for the time in the WHO 2007 classification. Management of such lesions remains controversial.
We describe the case of a 26-year-old female who presented with intracranial hypertension syndrome secondary to a 1.9 cm lesion of the pineal region causing hydrocephalus. The patient benefited from an endoscopic third ventriculocisternostomy and a biopsy of her lesion in favor of a papillary tumor of the pineal region. After discussion of the surgical risks, the patient refused the surgical option and a stereotactic radiosurgery (SRS) was performed. She improved both clinically (allowing her to regain autonomy) and radiologically (reduction of 60% of tumor volume) at 1 year follow-up.
Because of the rarity of the lesion, literature is yet not able to find consensus concerning management of such lesion, but SRS has proven efficiency for these Grades II or III lesions with high recurrence rates. Therefore, it should be considered as a primary therapeutic option allowing good outcome with low risks for the patient.
松果体区乳头状肿瘤是罕见的神经上皮性病变，首次在世界卫生组织2007年分类中被描述。此类病变的治疗仍存在争议。
我们报告一例26岁女性患者，因松果体区1.9 cm病变导致脑积水，出现颅内高压综合征。患者接受了内镜下第三脑室造瘘术，并对病变进行活检，结果支持松果体区乳头状肿瘤的诊断。在讨论手术风险后，患者拒绝手术，接受了立体定向放射外科治疗（SRS）。随访1年时，患者临床症状改善（恢复自主能力），影像学检查显示肿瘤体积缩小60%。
由于该病变罕见，目前文献尚未就其治疗达成共识，但SRS已被证明对这些复发率高的II级或III级病变有效。因此，应将其视为主要治疗选择，可为患者带来良好预后且风险较低。
