Rare Tumors (Oct 2011)

Pineocytoma with diffuse dissemination to the leptomeninges

  • Michael Selch,
  • Antonio De Salles,
  • Harry Vinters,
  • Whitney Pope,
  • Jeffrey Wu,
  • Caitlin Gomez

DOI
https://doi.org/10.4081/rt.2011.e53
Journal volume & issue
Vol. 3, no. 4
pp. e53 – e53

Abstract

Read online

Pineal parenchymal tumors are rare. Of the three types of pineal parenchymal tumors, pineocytomas are the least aggressive and are not known to diffusely disseminate. In this paper, we report the successful treatment of a case of pineocytoma with diffuse leptomeningeal relapse following initial stereotactic radiotherapy. A 39-year-old female presented with headaches, balance impairment, urinary incontinence, and blunted affect. A pineal mass was discovered on magnetic resonance imaging (MRI). A diagnosis of pineocytoma was established with an endoscopic pineal gland biopsy, and the patient received stereotactic radiotherapy. Ten years later, she developed diffuse leptomeningeal dissemination. The patient was then successfully treated with craniospinal radiation therapy. Leptomeningeal spread may develop as late as 10 years after initial presentation of pineocytoma. Our case demonstrates the importance of long-term follow-up of patients with pineal parenchymal tumors following radiation therapy, and the efficacy of craniospinal radiation in the treatment of leptomeningeal dissemination.

Keywords