Revised: Feb. 2004

Tumours of the pineal region are rare, comprising about 1% of intracranial lesions. The majority of these are germinomas in young patients. Other tumour types, arising from the parenchyma, include pineocytoma, pineoblastoma and astrocytoma.

The biologic behaviour of pineocytomas is not well known because of small patient numbers and variable behaviour. Those demonstrating neuronal or astrocytic differentiation may have a more favorable prognosis. Surgery and observation may be feasible with radiation reserved for progression or recurrence. There may be indications for focal radiotherapy.

Pineoblastomas are primitive neuroectodermal tumours (PNET). They tend to disseminate within the craniospinal axis, therefore, a staging MRI of the spine should be performed. Radiotherapy involves craniospinal radiation along with a boost to the primary. There may be a role for chemotherapy in selected patients(1).

Astrocytic tumours of the pineal are treated like astrocytomas at other intracranial sites. (see low grade astrocytoma and malignant astrocytoma.)

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