What Is a Pinealoma?

Pineal tumor refers to the increased secretion of gonadotropins and sex hormones caused by pineal tumors (the pineal gland's secretory function has an antagonistic effect on the pituitary gland), also known as precocious puberty syndrome, precocious giant genital giant syndrome. Common tumors include: pineal somatic cell tumors, pineal somatic cell tumors, glioblastomas, teratomas, germ cell tumors, seminoma, and astrocytomas, which account for about 1% of intracranial tumors. More common in boys. There are two main types of pineal cells: pineal parenchymal cells and glial cells. Germ cell tumors and teratoma are the most common pineal tumors. 75% to 80% of pineal tumors are malignant. These include germ cell tumors, pineoblastomas, and some gliomas. The rest are benign tumors, such as pineal somatomas, teratomas, and dermoid cysts.

Basic Information

nickname: Pineal germ cell tumor, precocious puberty syndrome, precocious giant genital megaloid syndrome
English alias: pinealoma
Visiting department: Oncology
Multiple groups: boy

Common causes: Pineal body teratoma villous tissue and germ cell tumor secrete hormones secreted by HCG; pineal gland is destroyed
Common symptoms: Precocious puberty, headache and vomiting, two eyes can't go up, oculomotor nerve palsy, make eye movement disorder, decrease vision, edema of optic nerve papillae, abnormal gait, etc.

Causes of pineal tumors

Both the villous tissue and germ cell tumor of the pineal teratoma can secrete hormones secreted by HCG, which is sufficient to cause precocious puberty. Such tumors have the histological and functional characteristics of chorionic carcinoma.

Pineal tumors lead to precocious puberty, which may affect the regulatory function of the hypothalamus or HCG secretion due to tumor compression or destruction. Neuroendocrine anatomy results suggest that premature puberty is caused by the expansion of other tumors in the brain into the pineal gland.

Another possible cause of precocious puberty is because the pineal gland produces a substance that inhibits the secretion of gonadotropins from the pituitary. For example, if the pineal gland is destroyed and the inhibitory effect disappears, precocious puberty may occur, and the tumor may pass beyond the pineal gland area, causing the first Hydrocephalus in the third ventricle or damage to the hypothalamus causes precocious puberty.

Clinical manifestations of pineal tumor

Some patients have precocious puberty; symptoms of tumor compression may include headache and vomiting; invading hypothalamus and other neuropsychiatric symptoms of hypothalamus; neurological symptoms are mainly the inability of the two eyes to ascend and oculomotor nerve paralysis, making eye movement disorders , Ataxia, changes in pupil reflex, including Al-Luo pupils, drowsiness, etc.

Tumors with dilated pupils appear when the quadruple is compressed, and the dyskinesia of both eyes with upward and downward vision is called quadrilateral syndrome. Can also cause cerebellar ataxia, endocrine symptoms have the characteristics of sexual precocious puberty, and sometimes due to tumor involvement of the third ventricle caused autonomic nerve disorders such as acromium. May have decreased vision, edema of the optic nerve papilla, and abnormal gait.

Pineal tumor examination

1. Patients with hormone-secreting germ cell tumor in the pineal gland have increased -HCG and AFP levels in the cerebrospinal fluid.

2. Cerebrospinal fluid shedding cytology is most valuable for diagnosing germ cell tumor and pineal gland tumor.

3. CT or MRI is mostly chosen based on clinical manifestations. CT is the first choice for pineal tumors. It can be used for enhanced and coronary CT scan-guided biopsy, and clear tissue diagnosis can be obtained locally at the lesion.

4. MRI has unique advantages in the diagnosis of pineal glioblastoma. Pineal glioblastoma has a large degree of malignancy, has the characteristics of infiltration, rapid growth, and easy metastasis, and the patient has a short survival period. Therefore, early diagnosis and treatment are very important. MRI showed high signal in the pineal tumor area and the extent of tumor invasion into the third ventricle was clearly visible.

5. The head radiograph showed signs of large (> 15mm) flocculent pineal calcification or cerebral edema.

Differential diagnosis of pineal tumor

Differential diagnosis should pay attention to distinguish tumors that occur outside the pineal gland, such as meningioma hemangioma; tumors in adjacent parts such as the brainstem cerebellar vermicompost; pineal gland cysts and other diseases are mainly based on the difference between pineal gland tumors Imaging examination, if there is precocious puberty, germ cell tumor is likely, and the final diagnosis depends on pathological examination. It should be differentiated from hypothalamic syndrome and Nothnagel syndrome.

Pineal tumor complications

Postoperative complications: intracranial hemorrhage, gastrointestinal bleeding, blood electrolyte disturbance, hyponatremia, hypernatremia, hypopituitarism, central febrile fever, diabetes insipidus, cerebrospinal fluid rhinorrhea, etc.

1. If the tumor presses the brain aqueduct to cause intracranial hypertension, the tumor presses the quadrilateral can cause the eyes to fail to look up, the pupils' reflection of light disappears, the eyes cannot converge, and large stride gait.

2. Tumors in the pineal gland can cause hypothalamic damage and cause diabetes insipidus.

Pineal tumor treatment

For the treatment of this disease, surgery and radiotherapy should be appropriate, and the target area should be designed according to the pathological results. Pineal glioblastoma, teratoma, and germ cell tumor are sensitive to chemotherapy. Teratomas are not sensitive to radiotherapy, but chemotherapy can achieve better results.

Prognosis of pineal tumor

The prognosis of patients with tumors in the pineal region varies depending on the type of histology, the severity of the condition, and the treatment.