Adult Pineoblastoma: A Rare Case Report

Abstract

Introduction: Pineoblastoma (PB) is a rare brain tumor considered as a variant of supra-tentorial primitive neuroectodermal tumor. They are poorly differentiated, infiltrative, and have significant potential for leptomeningeal and extra-cranial dissemination. Pineoblastoma has a predilection for the pediatric population, whereas in adults they are exceedingly rare and it accounts for approximately less than 1% of primary central nervous system tumors. The treatment for adult pineoblastoma consists of surgery followed by craniospinal radiotherapy with or without the addition of chemotherapy. Adult Pineoblastoma a rare tumor and needs to be considered in the differential diagnosis of pineal region tumors in adults. The reported case is noteworthy for the rarity of the clinicopathological entity.Case Presentation: The present case represents a total workup on diagnosing pineoblastoma including radiology, histopathology, and immunohistochemistry. A 33-year-old male patient presented with headache & vomiting. His MRI showed heterogeneously enhancing mass lesions in the pineal region. Excision biopsy from the mass showed histology of pineoblastoma which was confirmed with a complete immunohistochemistry (IHC) study.Conclusion: Though rare, Pineoblastoma needs to be considered a differential diagnosis of pineal region tumors in adults. Because of the considerable overlap in imaging appearance with other pineal region tumors, histopathology with immunohistochemistry is required along with radiology to confirm diagnosis. Our case had no extra-cranial dissemination and was treated by surgical excision followed by adjuvant cranial radiotherapy. Due to the rarity of pineoblastoma in adults, optimal treatment strategies and prognosis are yet to be determined.

Keywords

• pineoblastoma
• primitive neuroectodermal tumor
• adult