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Pineal Gland Neoplasm


Presentation

  • Present on Admission symbol identifies the diseases that will always be coded as present on admission. Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease.[books.google.com]
  • Patients often present with endocrine dysfunction secondary to involvement of the sellar region by tumour. Disseminated disease is commonly seen at the time of presentation as well as subependymal spread of the tumour along the third ventricle.[link.springer.com]
  • In one of two such tumors, retinoblastomatous features were present as well.[neurosurgery.tv]
  • Focal calcification was present in the adjacent pineal gland, which was displaced to the left. The pineal gland was normal on histologic examination. Case 2 A 51-year-old woman presented with a headache and impairment of upward gaze.[ajnr.org]
  • Teratomas , which are found almost exclusively in males and tend to present in the second decade of life with hydrocephalus Parinaud's syndrome (see 'Presentation', below) and, rarely, a chemical meningitis resulting from tumour rupture with release of[patient.info]
Precocious Puberty
  • Other symptoms may include hydrocephalus, gait disturbances, and precocious puberty.[en.wikipedia.org]
  • In children younger than 10, certain germ cell tumors may secrete hormones that can create an endocrinologic disturbance and lead to precocious puberty.[skullbaseinstitute.com]
  • Common physical examination findings of pineal choriocarcinoma include papilledema, signs of precocious puberty, restricted extraocular movements, sluggish pupillary light reflex, stiff neck, hemiparesis, and abducent nerve palsy. [5] Laboratory findings[wikidoc.org]
  • Less common symptoms, occurring in less than 10 percent of male patients with pineal tumors are precocious puberty or delayed onset of sexual maturation.[pinealomas.com]
  • Patients with brain tumours may present with a wide variety of symptoms such as headaches, drowsiness, fits, feeling of being sick, moments of unconsciousness, paralysis of upward or downward gaze, abnormalities of pupil, paralysis and precocious puberty[ispub.com]
Difficulty Walking
  • walking muscle weakness in the face, arm, or leg Symptoms of pituitary tumors The following symptoms can occur with pituitary tumors: nipple discharge, or galactorrhea lack of menstruation in women development of breast tissue in men, or gynecomastia[healthline.com]
  • walking Fatigue and sleepiness Problems with coordination Neck pain or stiffness Visual problems Treatment The doctor will perform tests to determine if it has spread to the spinal cord.[braintumor.org]
  • Also, if tumors develop near parts of the brain that control vital functions, they may cause problems, such as weakness, difficulty walking, loss of balance, partial or complete loss of vision, difficulty understanding or using language, and problems[merckmanuals.com]
Disability
  • Subjecting children to similar treatments can indiscriminately kill both cancerous and healthy cells, disrupting the development of the growing tissues which eventually could lead to long-term disability for the young patients ( 12, 13 ).[ispub.com]
  • However, unlike nonmalignant tumors elsewhere in the body, some of these brain tumors can cause disability and may sometimes be life threatening. In many cases, meningiomas grow slowly.[braintumor.org]
Hearing Impairment
  • Tremors Lack of coordination Hearing impairment- buzzing, ringing sound Drowsiness Changes in speech Behavior changes [2,3] Diagnosis Physical examination A lot of initial symptoms are unspecific and can be explained with other conditions.[cancerwall.com]
Strabismus
  • A 10-year-old girl presented with one-year history of right eye strabismus accompanied by diplopia, with no apparent cause.[spandidos-publications.com]
Vertical Gaze Palsy
  • Other features relating to these tumours include: [ 3 ] Parinaud's syndrome - vertical gaze palsy pupillary or oculomotor nerve paresis .[patient.info]
Vertical Gaze Palsy
  • Other features relating to these tumours include: [ 3 ] Parinaud's syndrome - vertical gaze palsy pupillary or oculomotor nerve paresis .[patient.info]
Headache
  • Some of the most common are Headaches, often in the morning Nausea and vomiting Changes in your ability to talk, hear, or see Problems with balance or walking Problems with thinking or memory Feeling weak or sleepy Changes in your mood or behavior Seizures[icdlist.com]
  • She suffered headaches two to three times per month. Each time, the headaches lasted for about an hour. She sometimes felt dizzy. QM was started on herbs and radiotherapy was deferred for the moment.[ispub.com]
  • Based on its location in the brain, a cyst can cause symptoms such as headache, pain, seizures, or a neurological deficit. Cysts can be surgically removed or drained.[braintumor.org]
  • The headache may be most intense when people awaken from sleep, then lessen later in the day. If headaches with these characteristics start in people who have not had headaches before, a brain tumor may be the cause.[merckmanuals.com]
  • Patients commonly present with headaches and ataxia ( 3 , 7-9 ). In general, the major primary symptoms include a headache with high intracranial pressure because of an increase of volume, ataxia, dysarthria, and vertigo ( 2 , 5 , 7 , 9 ).[qims.amegroups.com]
Nystagmus
  • Frequently, paralysis of upward gaze along with several ocular findings such as convergence retraction nystagmus and eyelid retraction also known as Collier's sign and Light Near Dissociation (pupil accommodates but doesn't react to light) are known collectively[en.wikipedia.org]
  • The most common is Parinaud's syndrome, which includes inability to look upward, double vision and nystagmus, or flickering of the eyes back and forth.[neurosurgery.ucla.edu]
  • Compression of the adjacent brain structure the Superior Colliculus causes visual disturbance, the most common of which is Parinaud's Syndrome (inability to look upward, double vision and nystagmus - a flickering of the eyes back and forth).[neurosurgerydallas.com]
  • . • Visual Problems • Parinaud's syndrome, which includes inability to look upward, double vision and nystagmus 4.[slideshare.net]
  • Symptoms include: Inability to focus on an object Double vision Eye movement impairment- inability to look upward Nystagmus Other symptoms: If the tumor invades thalamus, it is possible to lose sensation and motor function in one half of the body.[cancerwall.com]
Ataxia
  • Motor impairment (eg ataxia and dysmetria ) if there is cerebellar involvement. If the thalamus is involved, there may be unilateral paraesthesia .[patient.info]
  • Patients commonly present with headaches and ataxia ( 3 , 7-9 ). In general, the major primary symptoms include a headache with high intracranial pressure because of an increase of volume, ataxia, dysarthria, and vertigo ( 2 , 5 , 7 , 9 ).[qims.amegroups.com]
  • Ataxia and dysmetria can result due to interference of superior cerebellar peduncles. Rarely, there may be hearing disturbances due to disturbance of inferior colliculi. Endocrine disturbance is rare due to tumor spread to hypothalamus.[thamburaj.com]
  • […] intracranial pressure (ICP) Symptoms of brain tumors in the cerebellum (back of brain) may include: Increased intracranial pressure (ICP) Vomiting (usually occurs in the morning without nausea) Headache Uncoordinated muscle movements Problems walking (ataxia[chw.org]
  • Fig. 7 Teratoma in a 56-year-old man with worsening confusion and ataxia.[link.springer.com]
Papilledema
  • Common physical examination findings of pineal choriocarcinoma include papilledema, signs of precocious puberty, restricted extraocular movements, sluggish pupillary light reflex, stiff neck, hemiparesis, and abducent nerve palsy. [5] Laboratory findings[wikidoc.org]
  • Clinical features: Clinically, there are features of hydrocephalus, such as, headache, vomiting, and papilledema.[thamburaj.com]
  • Papilledema may not be evident, even in the presence of severe intracranial hypertension, because of the associated optic atrophy. Visual field studies may demonstrate bitemporal inferior scotomas, indicating a lesion on the dorsum of the chiasm.[pinealomas.com]
  • .), reduction in visual acuity and visual fields and papilledema. Continue with the MR images. Notice the normal inferiorly displaced pituitary gland. This means it is not a macroadenoma. The diagnosis is again a craniopharyngioma.[radiologyassistant.nl]
Severe Headache with Sudden Onset
  • In rare cases, vascular anomalies and pineal tumours can haemorrhage into the pineal gland, referred to as pineal apoplexy, and present with severe headache of sudden onset [ 6 ].[link.springer.com]

Workup

  • Therefore, a rigorous and uniform preoperative workup is a requisite for all patients thought to harbor a pineal region tumor. Any endocrine abnormalities should be investigated prior to surgery.[emedicine.medscape.com]

Treatment

  • , and treatment strategies for traumatic brain injury in soldiers.[books.google.com]
  • Treatment options include watchful waiting, surgery, radiation therapy, chemotherapy, and targeted therapy. Targeted therapy uses substances that attack cancer cells without harming normal cells. Many people get a combination of treatments.[icdlist.com]
  • Surgery is the standard treatment.[braintumor.org]
  • The main treatments for pineal region tumours are surgery, radiotherapy and sometimes chemotherapy. Your treatment depends mainly on the type of pineal region tumour you have.[macmillan.org.uk]
  • Being well informed about your tumour and its treatment can make it easier to make decisions and cope with what happens. Follow up You will have regular check ups once you finish your treatment.[cancerresearchuk.org]

Prognosis

  • Staging determines the prognosis of the cancer as well and provides uniformity of care.[news-medical.net]
  • You can help by adding to it. ( November 2017 ) Prognosis [ edit ] Of the different types of pinealomas, the type with the most favorable prognosis is the pineocytoma. [3] References [ edit ] Gaspar N, Verschuur A, Mercier G, Couanet D, Sainte-Rose C,[en.wikipedia.org]
  • Prognosis The prognosis highly depends on the type of tumor. Usually germ cell tumors have excellent prognosis, because they are responsive to radiation and chemotherapy. Non germ cell tumors have a worse prognosis.[cancerwall.com]
  • Prognosis The response of tumours to various treatment modalities depends on the tumour subtype. [ 3 ] Generally, intracranial germinomas have an excellent prognosis on account of their sensitivity to radiotherapy (the five-year overall survival rate[patient.info]
  • Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options for primary brain and spinal cord tumors depend on the following: The type and grade of the tumor.[my.clevelandclinic.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease.[books.google.com]

Epidemiology

  • J Neurosurg. 1979 ; 51 : 597 -607. 17 Surveillance, Epidemiology, and End Results (SEER) Program. 1973-2001 Public-Use CD-ROM.[academic.oup.com]
  • Epidemiology [ 3 ] They account for 0.4-1% of adult intracranial tumours . They make up 3-8% of childhood intracranial tumours, with most occurring between the first and second decade of life.[patient.info]
  • Currently, initial surgical management for tissue diagnosis, and possible resection, is the standard of care for most children with pineal region tumors. [16] Epidemiology Pineal region tumors make up 0.4-1.0% of intracranial tumors in adults and 3-8%[emedicine.medscape.com]
  • Epidemiology The term “pineal region tumors” includes both the neoplasms originating from the pineal body and the neoplasms originating from the adjacent anatomical structures, such as the thalamus, the tegmentum of the midbrain, and the falcotentorium[plaza.umin.ac.jp]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Normal pineal gland: The pineal gland is composed of pineocytes (95%) and supporting glial cells (5%) ( 22, 34 ). Pineocytes are the principal parenchymal neurons of the pineal gland and function as neuroendocrine transducers.[ispn.guide]
  • The pathophysiology of pineal region tumors is mostly a result of anatomic compression of adjacent structures, although local infiltration of neural structures can lead to symptoms in cases of highly invasive tumors.[emedicine.medscape.com]

Prevention

  • Chemotherapy Radiation therapy Steroids (to treat and prevent swelling especially in the brain) Anti-seizure medication (to treat and prevent seizures associated with intracranial pressure) Ventriculoperitoneal shunt (Also called a VP shunt) - A VP shunt[chw.org]
  • […] used to treat brain tumors include: Chemotherapy (cancer drugs) Radiation therapy (high-energy rays that kill or shrink cancer cells) Proton therapy (a precise form of radiation therapy that is less damaging to surrounding tissue) Steroids to treat and prevent[chop.edu]
  • The outlook for a brain tumor will depend on: the type of tumor the size of the tumor the location of the tumor your general health Early treatment can prevent complications that can occur as a tumor grows and puts pressure on the skull and brain tissue[healthline.com]
  • Radiation After surgery, radiation therapy is used to kill leftover tumor cells and try and prevent recurrence.[braintumor.org]
  • Drugs such as mannitol and corticosteroids are usually given by injection to reduce the pressure and prevent herniation. They reduce swelling around the tumor.[merckmanuals.com]

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