[Pineocytoma--a case report].

A report on a rare case of pineocytoma is presented. A 27-year-old woman visited our clinic because of a 3-month history of intermittent headaches and nausea. A CT scan revealed the presence of a marked obstructive hydrocephalus and mass without any contrast enhancement in the pineal region. Immediately, V-P shunting was performed and resulted in relief of all symptoms. Ventriculography showed a complete occlusion at the aqueductus Sylvii and filling defect at the posterior part of the 3rd ventricle. The patient was operated on in the prone position via infratentorial supracerebellar approach by suboccipital craniectomy on November 9, 1982. A grayish red-colored, well-defined solid tumor located at the pineal region was removed partially. The histopathological appearance of this tumor resembled the pattern of the normal pineal gland. Many cells exhibited a polar form, eosinophilic cytoplasm with the process often being directed toward a blood vessel. The cells around the central areas occupied by pale eosinophilic material were arranged like a "rosette". Combined chemo-radiotherapy was carried out after surgery. That is, a total dose of 4,825 rads to the whole brain was irradiated, and ACNU 140 mg and VCR 6 mg in total were administered intravenously and intermittently. After irradiation therapy, the tumor increased in size producing a ring-like enhancement effect as shown on repeated CT scans. During this time, she started to complain of blurred vision with Parinaud's sign. A second operation via interhemispheric approach by right parietal craniotomy was undergone, and the tumor was partially resected again on March 29, 1983.(ABSTRACT TRUNCATED AT 250 WORDS)