Extraneural metastases from primary pineal tumors. Review of the literature.

Extraneural metastases from primary pineal tumors are extremely rare: only 15 such cases could be found in th literature. Another case is presented of a 10-year-old boy who developed multiple pulmonary and skeletal metastases from a presumed primary pineal germinoma. The incidence and pathogenesis of distant dissemination in the different types of pineal tumors are discussed, with special comment on the controversial role of the direct surgical approach and shunting of cerebrospinal fluid.