Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India.
Neurol India. 2021 Sep-Oct;69(5):1153-1164. doi: 10.4103/0028-3886.329550.
Pineal parenchymal tumors account for less than 0.3% of all CNS tumors and "Pineal parenchymal tumor of intermediate differentiation" (PPTID; World Health Organization (WHO) grades II and III) exhibit intermediary differentiation and prognosis. However "Papillary tumor of the pineal region" (PTPR; WHO grades II and III) is a distinct entity.
This combination of rarity and apparent similarity often leads to perplexity regarding the treatment and prognosis among neurosurgeons. In this review, we have tried to elucidate the differences in clinical as well as treatment modalities and outcomes of these two entities.
We used the PubMed Database to search for all relevant articles using the keywords "pineal parenchymal tumor of intermediate differentiation" and "Papillary tumor of the pineal region." Articles having details regarding demographic and clinical variables along with treatment and outcomes were chosen for this study. Full text of these articles was analyzed, and data tabulated.
A total of 25 articles for PPTID and 45 for PTPR were found suitable for inclusion in this study. The studies were either case reports or small retrospective series with only one systemic review for each pathology. Despite the poor quality of data, some trends were apparent. Surgical resection offered a survival benefit in both pathologies. Radiotherapy was effective in increasing the survival in PPTID, while there was little to no effect in PPTR. Chemotherapy was not found to be beneficial in either.
Both of these tumors have moderate growth rate and potential for malignant behavior. This continuum of characteristics makes their optimal treatment strategy difficult and confusing. The discussion on comprehensive literature review should give information for neurosurgeons to decide on optimal treatment strategies.
松果体实质肿瘤占所有中枢神经系统肿瘤的不到 0.3%，“松果体实质肿瘤中度分化”（世界卫生组织 [WHO] 分级 II 和 III）表现出中间分化和预后。然而，“松果体区乳头状肿瘤”（WHO 分级 II 和 III）是一个独特的实体。
这种罕见性和明显相似性的结合常常导致神经外科医生在治疗和预后方面感到困惑。在这篇综述中，我们试图阐明这两种实体在临床和治疗方式以及结果方面的差异。
我们使用 PubMed 数据库，使用关键词“松果体实质肿瘤中度分化”和“松果体区乳头状肿瘤”搜索所有相关文章。选择了具有人口统计学和临床变量以及治疗和结果详细信息的文章进行本研究。分析这些文章的全文，并进行数据制表。
共找到 25 篇关于 PPTID 的文章和 45 篇关于 PTPR 的文章，适合纳入本研究。这些研究要么是病例报告，要么是小的回顾性系列，每个病理学只有一篇系统评价。尽管数据质量较差，但仍出现了一些趋势。手术切除在两种病变中都提供了生存获益。放疗在 PPTID 中增加了生存获益，而在 PTPR 中则几乎没有效果。化疗在两种情况下都没有被发现是有益的。
这两种肿瘤生长速度适中，具有恶性行为的潜力。这种特征的连续性使得它们的最佳治疗策略变得困难和令人困惑。对综合文献综述的讨论应该为神经外科医生提供信息，以决定最佳的治疗策略。
