7Okmeydanı Eğitim ve Araştırma Hastanesi Aneztezi ve Reanimasyon Kliniği, İstanbul OBJECTIVES: Pineal region tumors are rarely seen in the central nervous system. The management of the pineal region tumors have remarkably changed since 1980 and different treatment strategies have been suggested. In this report, we present a series of pineal region tumours with their follow up that had been operated in our clinic between 1997-2004 by reflecting our surgical and clinical experiences about pineal region tumors.
STUDY DESIGN: Twenty-three pineal region tumor patients were evaluated retrospectively who had been operated in our clinic between 1997-2004. 12 of the patients were males and 11 patients were females. The age of the patients were between 10 and 55 (average 29.3). BT, MRI, DSA tumor markers were used for the diagnosis and follow up of the patients. Pineal region surgery was performed for 21 patients and V-P shut was performed for 1 patient. One patient was not operated. As a surgical approach to the pineal region majorly infratentorial supraserebellar approach was used. Alternatively occipital transtentorial and Van Wagenen procedures were used.
RESULTS: %95 of the patients were treated surgically. The histopathological diagnosis of 5 patients were epidermoid tumor, 5 patients; astrositoma, 3 patients; meningioma, 4 patients; germinoma, 2 patients; pineblastoma, 2 patients; pineal cyst, 1 patient; pineal calsification and 1 patient was undefined. The complication for the operated patients were; spinal seeding in 2 patients, hemianopsia in 1 patient, exitus in one patient after one month due to menigitis. Ratio of mortality and morbidity were %4, %13 respectively.
CONCLUSlON: Histopathological diagnosis of the pineal region tumors in this series were mostly benign in nature when compared to the previously reported series in the literature. The ratio of mortality and morbidity were smilar to the literature. The management of pineal region tumors has changed a lot in the last 20 years. Today the developments in microsurgery, neuroanesthesia and radiological diagnostic tools have remarkably decreased the rate of mortality and morbidity. The open surgical approach to the pineal region tumors is an effective and safe method of treatment.
Anahtar Kelimeler : Chemotherapy, Surgical apporach, Pineal region, Radiotherapy