Cases reported "Pinealoma"

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1/22. Pineal malignant rhabdoid tumor with chondroid formation in an adult.

    A pineal tumour in a 27-year-old male is presented with the characteristic histological features of a pineal malignant rhabdoid tumor (MRT) with chondroid formation. Occasionally, tumor cells contained a single well-demarcated hyaline globular inclusion within the cytoplasm adjacent to the nucleus. The stroma of these tumors tends to be densely hyalinized and become chondroid. Immunohistochemical staining was positive for vimentin, epithelial membrane antigen, chromogranin a, synaptophysin, neuron-specific enolase, S-100 protein, and muscle actin. Despite surgery and radiochemotherapy, the tumor recurred in the pineal region and metastasized to the lower lobe of right lung. The patient died 2 years after the initial diagnosis. This is the second published case of central nervous system-MRT appearing in an adult. The clinical and pathological features of pineal MRT in this patient are presented.
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2/22. Cytogenetic and ultrastructural study of a pineocytoma case report.

    The authors report a case of pineocytoma in a 44-year-old woman suffering from headache, vomiting and Parinaud syndrome. At histopathological examination the neoplasm showed a ill-defined lobulate pattern with some small pineocytomatous rosettes. The electron-microscopy revealed cells of moderate size and oval nuclei with smooth nuclear envelopes; well-developed organelles were found in the, abundant cytoplasm. The chromosome analysis revealed this kariotype: 58-59, XXX, -4, -5, -13, - 14, -15, 19. This is the first report of a pineocytoma with ultrastructural and cytogenetic study; it confirms the literature findings of the electron-microscopy, whereas there is partial accordance with the previous cytogenetic studies.
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keywords = rosette
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3/22. Postoperative cortical venous infarction in tumours firmly adherent to the cortex.

    It is sometimes difficult to separate extra-axial tumours from the cortical veins in case of tumours attaching tightly to the cortex and the cortical veins. We present two patients having a postoperative cortical venous infarction. A 59 year old female had convexity meningioma above the motor cortex where abnormal cortical anastomotic veins developed. Transient hemiparesis occurred after total removal of the tumour because of venous infarction and cyst formation resulting from sacrifice of these veins which were tightly adherent to the tumour surface. A 15 year old boy with immature teratoma of the pineal region, showing several draining veins around the vascular-rich tumour, presented transient drowsiness, diplopia and partial impairment of bilateral visual acuity postoperatively because of localised cortical brain and venous damage. It is important to make an effort to preserve main cortical veins during operation as much as possible, even if the tumour adheres to the cortical surface.
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4/22. Pineal parenchymal tumor with marked retinoblastic differentiation: case report.

    A 53-year-old woman was found to have a tumor in the pineal region. Histologically, Homer-Wright rosettes were sporadically distributed in a diffuse proliferation of round tumor cells that were immunoreactive for synaptophysin and chromogranin. A few perivascular pseudorosettes were also present, and the perivascular tumor cells were immunoreactive for glial fibrillary acidic protein and vimentin. By electron microscopy, well-developed junctions and pronounced interdigitation of abutting plasma membranes were noted in many tumor cells, as well as abundant intracytoplasmic microtubules. These findings indicated that the tumor was a pineal parenchymal tumor accompanied by an extraordinary epithelial-like differentiation, suggesting retinoblastic photoreceptor cell differentiation.
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keywords = rosette
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5/22. A pineal tumour with features of "pineal anlage tumour".

    A primitive tumour of the pineal region in a 9 month-old boy caused hydrocephalus, ataxic gait and paraplegia leading to death after 9 months of evolution. Histological and histochemical examination revealed a pinealoblastoma with melanotic cells as well as cartilaginous formations. The leptomeningeal seeding of the tumour showed neuroblastic and neuronal differentiation. A diagnosis of pineoblastoma with neuroepithelial and ectomesenchymal differentiation was made. This tumour belongs to a recently defined category of pineal tumours, called pineal anlage tumours.
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6/22. Treatment strategy of pineal tumors in consideration of their pathomorphology.

    BACKGROUND: Tumors of the pineal gland are rare pathology. This paper reports on therapeutical considerations of histologically heterogeneous pineal tumors in a group of 15 patients and is presenting a special case of neuroaxial seeding. methods: Surgery and/or additional therapeutic procedures were performed in 13 of our 15 patients ("youngster" and "adults") in respect of pathomorphology. Details are reported concerning a 52-year-old man suffering from pineocytoma (WHO grade II), who underwent different kinds of therapy within 10 years follow-up. RESULTS: In the six "youngster" the histological assessment revealed two teratomas, one mixed pineocytoma/pineoblastoma, one astrocytoma and one epidermoid cyst. All neoplasms were treated surgically with good results. Additional radio-/chemotherapy was used in a case of teratoma and pineocytoma/pineoblastoma. From five successfully surgically treated "adults" (germinoma, pineoblastoma, pineocytoma, two cystic formations) in two of them (germinoma, pineoblastoma) additional radiotherapy was needed, another two patients (cystic formations) were healed after stereotactic puncture. The patient with pineocytoma showed recurrent neuroaxial seeding within 10 years in spite of repeated radiotherapy, though his neurological status remained stable (Karnofsky performance score of 100). CONCLUSION: Precise histopathological assessment of pineal tumors is essential to guide optimal modern therapy modalities in order to assure a local tumor control. (Fig. 3, Ref. 18.).
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7/22. Pineocytoma with neuronal differentiation--case report.

    The authors describe a case of pineocytoma studied by light and electron microscopy and the immunoperoxidase method. The tumor consisted of two types of cells bearing either chromatin-rich or pale nuclei. These cells were arranged in rosettes and contained pale, eosinophilic material at the center, or in lobular patterns with thin connective tissue and a few blood vessels. Bodian silver staining disclosed a delicate tangle of argyrophilic fibers and processes with small, club-like terminations. These findings are characteristic of pineocytoma. On ultrastructural examination, the tumor cells were found to be closely packed, in clumps separated by numerous fine or expanded, interlacing processes, some of which contained microtubules. A few dense core vesicles and clusters of clear vesicles similar to synaptic vesicles were seen, the latter being aggregated around desmosome-like thickenings in the cellular membrane, suggestive of a synaptic complex. Some tumor cells were positive for neuron-specific enolase and S-100 protein. Only a few cells positive for glial fibrillary acidic protein were distributed in the tumor tissue, but it was not ascertained if they were tumor cells or normal, pre-existing astrocytes. The tumor was diagnosed as a pineocytoma with neuronal differentiation.
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keywords = rosette
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8/22. Neuroepithelial and ectomesenchymal differentiation in a primitive pineal tumor ("pineal anlage tumor").

    A primitive tumor of the pineal region in a 9-year-old girl led to death after 5 months of increased intracranial pressure with occlusive hydrocephalus. Histological investigation including immunocytochemistry revealed a broad spectrum of neuroectodermal differentiation with neuroblastic, neuronal, ependymal and retinoblastomatous features. Melanotic epithelial formations were similar to those of the so-called retinal anlage tumor and of the developing pineal gland. Striated muscle fibers indicated additional ectomesenchymal differentiation reminiscent of the close topographical relationship between neural crest and neural tube on the prosencephalic level of the pineal anlage. This developmental situation seems to be neoplastically reflected by the differentiation features of this tumor.
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9/22. Ectopic pinealoma in the region of the optic chiasma.

    The authors report the case of a 31-year-old female patient who 10 years earlier had displayed diabetes insipidus and hyperglycemia and for 4 years galactorrhea and amenorrhea. Since one year her visual acuity had gradually declined to blindness. CT-scan revealed the presence of a tumoural formation in the optic chiasma and hypothalamic region. The histological examination of the operative-removed tumour showed that it was a type B pinealoma. The postoperative course was good for 42 hrs after which the patient died suddenly. Necropsy disclosed the presence of a myocardial infarct. The authors distinguish three categories of ectopic pinealoma: 1. tumours of the pineal gland with an aberrant development at the level of the 3rd ventricle, 2. metastatic pinealoma, and 3. ectopic pinealomas with an independent development in patients with normal pineal gland. The case reported below is of the 3rd category which is also the most veridical.
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10/22. Radiological and pathological findings in three cases of childhood pineocytomas.

    The radiological and pathological findings in three children with pineocytomas are described. The patients presented with symptoms and signs of increased intracranial pressure. CT scans demonstrated obstructive hydrocephalus, but failed to visualize pineal masses that were subsequently seen on MR scans. A suboccipital, supracerebellar approach was used to obtain tissue for histological diagnosis and, in one case, achieve a total removal. light microscopy demonstrated typical pineocytomatous rosettes without evidence of gangliocytic or astrocytic differentiation. Electron microscopy revealed numerous dense core vesicles with synaptic ribbons, suggesting neurosecretory capability. These three cases demonstrate the diagnostic advantage of MR imaging for tumors in the pineal region as well as the relatively well-differentiated histopathological characteristics of pineocytomas.
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ranking = 271.28767774282
keywords = rosette
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