ABSTRACT
A retrospective analysis was made of 20 patients with pineal region tumors who were treated at the Department of Neurosurgery, Capital Armed Forces General Hospital between May of 1987 and March of 1993. We performed ventriculo-peritoneal shunt in 17 patients with obstructive hydrocephalus. Tissue diagnosis was obtained in 7 patients before irradiation and 13 patients underwent irradiation without histological diagnosis. Among 7 biopsy-proven cases, 5 were germinoma, one was mixed germ cell tumor and another one was astrocytoma. The response to irradiation and tumor marker study revealed that 13 patients who did not have tissue diagnosis seemed to be germinomatous, non-germinomatous germ cell tumors and endodermal sinus tumor. So, the following results were obtained. 1) The patients were all young males. 2) The main presenting symptoms and signs were headache, vomiting and papilledema. 3) The tumors were mainly presented as a round well-enhancing masses with calcification. 4) Based on the classification of pineal tumor, germinoma was predominant tumor type. 5) The extrapineal metastasis was found in 5 cases(25.0%). 6) The tumor marker (alpha-FP or HCG) was positive in 5 cases(25.0%). 7) Germinoma showed excellent prognosis after the irradiation.
Subject(s)
Humans , Male , Arm , Astrocytoma , Classification , Diagnosis , Endodermal Sinus Tumor , Germinoma , Headache , Hospitals, General , Hydrocephalus , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal , Neurosurgery , Papilledema , Pinealoma , Prognosis , Radiotherapy , Retrospective Studies , Ventriculoperitoneal Shunt , VomitingABSTRACT
A 67-Year-old male patient was adimitted due to aggravation of long-standing left moter weakness. Past history revealed weakness of left extremity for 20 years caused by CVD attack. On adimission, his mental state was drowsy and brain CT scan showed a round mass mimicking a brain tumor in the frontal horn of right lateral ventricle with asymmetric dilatation of lateral ventricles. After failed carotid angiography due to vascular tortuosity, his mental state was progressively deteriorated and left hemiparesis aggravated. A right external ventricular drainage was done, and 5 days later a craniotomy was performed under the impression of the intraventricular tumor causing obstruction of right foramen of Monro, but a large thrombosed aneurysmal sac was found intraoperatively. Retrial of carotid angiography revealed a large anterior communicating artery aneurysm. After second operation, maningoencephalitis with wound infection was complicated. Twenty days after second operation, clipping of the aneurysmal neck with removal of partially thrombosed aneurysmal sac was performed successfully.