RESUMEN
BACKGROUND: Pineal region tumor is a rare and reportable case. Incidence rate adults is 0.025 in 10,000 hence there is no established guidelines among adults for diagnosis and management of this case.CASE: A case of a 20-year-old male with a two-month history of intermittent headache, occipital area with VAS 5/10,increasing in severity. Until two days prior to admission with severe headache VAS 9-10/10, occipital, and nonradiating.Patient noted episodes of projectile vomiting hence,admitted. Patient presented with non-lateralizing symptoms but noted papilledema and parinaud syndrome.Cranial MRI with contrast revealed a 2.5cm pineal gland tumor with obstructive hydrocephalus. Serum AFP (alpha-fetoprotein ) and beta-HCG (beta subunit of human chorionic gonadotropin) were requested and revealed elevated levels.The patient underwent endoscopic third ventriculostomy but no biopsy was done due to high risk of bleeding. Patient underwent series of radiotherapy and was advised to undergo chemotherapy but patient refused. Patient had improved upward gaze but with residuals, no recurrence of headache or vomiting, had normalization of the serum tumor markers but noted increase in size of the tumor despite radiotherapy.CONCLUSION: Case reports of pineal region tumors will help doctors in the primary hospitals diagnose such cases and differentiate it from benign causes of headache. This will aid in early referral to specialists and early intervention.