Pineoblastoma

Diagnosis:

Suggested by MRI and confirmed by pathology (brain biopsy/resection)

Clinical features:

Parinaud syndrome
Hydrocephalus

Findings on Investigations:

MRI:

  • Pineal mass
  • Contrast enhancement
  • CSF leptomeningeal metastasis can occur

CSF analysis:

  • leptomeningeal metastasis can occur

Pathology:

Histology:

  • Small round blue cell tumor, high nuclear cytoplasmic ratio. Homer-Wright (around neuritic processes) & Flexner-Wintersteiner Rosettes (around lumen). Necrosis & mitosis may occur.

Immunohistochemistry: positive for= synaptophysin, NSE, neurofilament, Class III beta tubulin, chromogranin, retinal S antigen. Rarely GFAP positive

Treatment:

Options:

  • Surgery
  • Radiation therapy
  • Chemotherapy

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