Eye and Brain (Apr 2023)
Diagnosis and Management of Pineal Germinoma: From Eye to Brain
Abstract
David Cohen,1 N Scott Litofsky2 1Department of Neurology, University of Missouri School of Medicine, Columbia, MO, USA; 2Department of Neurosurgery, University of Missouri School of Medicine, Columbia, MO, USACorrespondence: N Scott Litofsky, Department of Neurosurgery, One Hospital Drive, MC, 321, Columbia, MO, 65212, USA, Tel +1-573-882-4908, Fax +1-573-884-5184, Email [email protected]: Pineal germinomas can be very complex in terms of presentation, diagnosis, and management. This review attempts to simplify this complexity in an organized manner, addressing the anatomic relationships that provide the basis for the uniqueness of pineal germinoma. Ocular findings and signs and symptoms of elevated intracranial pressure are the keys to suspecting the diagnosis and obtaining the necessary imaging and cerebrospinal fluid studies. Other symptoms can suggest spread beyond the pineal region. Surgery may only be needed to obtain tissue for a definitive diagnosis, as germinoma is highly responsive to chemotherapy and focused radiation therapy. Hydrocephalus, usually related to tumor obstruction of the cerebral aqueduct, may also need to be addressed. Outcome for pineal germinoma is usually excellent, but relapse can occur and may require additional intervention. These issues are detailed in this review.Keywords: pineal germinoma, signs and symptoms, ocular findings, management, anatomy
