Analysis of treatment strategies and efficacy of pineal region lesions(a report of 55 cases)

Yang Chen; Song Zhaoming; Gu Jingyu; Chen Zhouqing; Wang Zhong

doi:10.11850/j.issn.1009-122X.2024.10.003

Abstract：Objective To explore the treatment strategy and prognosis of pineal region occupancy.Methods The clinical data of 55 patients with pineal region lesions were analyzed retrospectively.Among them,42 were treated with microsurgery,3 were treated with radiotherapy and chemotherapy,and 10 were treated conservatively.Follow-up was performed to evaluate the prognosis.Results Among the 42 operated patients,40(95.2%)underwent total resection and 2(4.8%)received subtotal resection.Thirteen cases were treated non-surgically,and no tumor or cyst enlargement was observed.Pathological examination confirmed benign tumors were seen in 19 cases,including 15 meningiomas,2 lipomas,and 2 pineal cyst;malignant tumors were 23 cases,including 9 pineal parenchymal tumors,8 germ cell tumors,3 gliomas,1 atypical meningioma,1 primitive neuroectodermal tumor,and 1 solitary fibrous tumor/hemangiopericytoma.The remaining lesions were diagnosed based on imaging findings,cerebrospinal fluid,and serum tumor marker tests,including 1 lipoma,2 pineocytomas,2 germ cell tumors,and 8 pineal cysts.One patient died due to complications resulting in deterioration of the condition,54 patients were followed up for 1 month to 10 years,with a 1-year survival rate of 90.1%,a 3-year survival rate of 89.7%and a 5-year survival rate of 85.7%.Conclusions For pineal region masses,microsurgery has a good effect on benign tumors,and microsurgery combined with postoperative radiation therapy and chemotherapy can also improve the prognosis of malignant tumors.Germ cell tumors are sensitive to radiotherapy,and radiotherapy should be the first choice.For pineal region tumors,microsurgery is the best way to cure them,and choosing the right surgical approach is the key to successful surgery.