Microsurgical Treatment of Pineal Tumors: Anatomy and Techniques

World Neurosurg. 2024 Apr:184:86. doi: 10.1016/j.wneu.2024.01.015. Epub 2024 Jan 10.

Abstract

Pineal region tumors are challenging lesions in terms of surgical accessibility and removal.1 The complexity is compounded by the infrequency and heterogeneity of pineal neoplasms.2,3 In Video 1, we present the case of a 39-year-old woman who presented with progressive headaches and vision impairment. She underwent microsurgical resection for a pineal parenchymal tumor of intermediate differentiation. We discuss the rationale, risks, and benefits of treatment for this patient, as well as provide a detailed overview of the alternative approaches that may be considered. Additionally, we discuss the unique anatomic considerations for each approach and include a virtual reality-compatible 3-dimensional fly-through to highlight the relationship between the tumor and relevant venous anatomy. The patient tolerated the procedure well with excellent neurologic outcome, and her follow-up imaging showed no evidence of tumor recurrence.

Keywords: Microsurgical resection; Pineal neoplasm; Pineal parenchymal tumor; Pineal region tumor; Virtual reality.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adult
  • Brain Neoplasms* / surgery
  • Female
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Pineal Gland* / diagnostic imaging
  • Pineal Gland* / pathology
  • Pineal Gland* / surgery
  • Pinealoma* / diagnostic imaging
  • Pinealoma* / pathology
  • Pinealoma* / surgery
  • Veins