A Study of Therapeutic Modalities of Pineal Region Tumors

The management of pineal region tumors remains controversial. Advocates of a conservative approach emphasize the excellent results of radiotherapy, particularly with germinoma, while a number of recent reports have demonstrated the safety of direct surgery. We analyzed 8 cases of pineal region tumors which had been treated at our institution over the past 7 years. Tissue diagnosis was obtained in 3 patients before irradiation and 5 patients underwent irradiation without histological diagnosis. Among 5 irradiated patients initially, four patients had been achieved complete remission by radiotherapy thus they were presumptively germinoma, but other one patient had no response, so she had been underwent surgery. Among 3 biopsy proven cases, 2 were teratoma and other one was embryonal carcinoma. Complete gross microsurgical excision of well encapsulated tumor was possible in two teratoma cases. MRI and other neuroradiological studies have ben found to be useful in indicating the biological nature and histological type of pineal tumor. So, consideration of MRI scans together with tumor markers and response to small dose irradiation will generally allow a specific diagnosis with a high degree of probability. In this way, germinomas may be selected for radiotherapy and the tumor less likely to response may be subject to primary surgery to obtain complete tumor extirpation or tissue diagnosis.

Successful Removal of Hemangioblastoma Originating in the Medulla Oblongata: Report of 1 Case

Solid hemangioblastomas of the medulla oblongata are benign vascular neoplasms located in a critical area. We experienced a case of solid hemangioblastoma originated in the medulla oblongata with the syrinx in the cervical spinal cord. Preoperative magnetic resonance imaging provided precise anatomical location and radiologic features of the tumor, which facilitated its total removal. Cardiovascular and pulmonary disorders often complicate this type of surgery, and postoperative dysphagia is a frequent sequelae.

Multiple Meningioma: Case Report

Despite of their frequent occurrence among the brain tumor, meningiomas are rarely seen as a multiple growth. Most authors report an incidence ranging from 1 to 3% of all meningioma prior to the introduction of computed tomography. After the CT has introduced, diagnostic problems involved with multiple meningiomas were resolved, and its reported incidence was arisen to 8~8.9% of all meningiomas. It may be difficult to differenciate multiple meningioma from the special varient(forme fruste) of von Recklinghausen's disease. Although the pathogenetic factors related to the multiple meningiomas are unknown, various theories of the etiology have been studied and reported. We report a patient with multiple meningioma without evidence of von Recklinghausen's diseases.

A Case of Chondroma in Middle Cranial Fossa: Case Report

Intracranial chondromas are extremely rare tumors, but when present, are generally related to the synchondrosis of the base, and they have several distinct features. They are slow growing benign tumors, and plain roentgenogram frequently reveals lytic lesion and stippled calcification at base of the skull. They are radioresistant, and surgical removal is treatment of choice. We report the rare case of chondroma arisen from base of the skull which diagnosed by brain CT and confirmed by operation.