Recurrent Pineocytomalike Papillary Tumor of The Pineal Region: A Case Report and Literature Review

World Neurosurg. 2018 Dec:120:1-14. doi: 10.1016/j.wneu.2018.08.125. Epub 2018 Aug 27.

Abstract

Background: Papillary tumors of the pineal region (PTPRs) are malignant World Health Organization grade II/III tumors; however, they may perfectly mimic benign tumors (e.g., pineocytomas [World Health Organization grade I]).

Case description: We present a case of a 28-year-old man with a 35-mm tumor of the pineal region. Considering the typical radiological and pathologic presentation, the tumor was first diagnosed as pineocytoma. However, despite first total resection, the tumor recurred after 7 years. The recurrent neoplasm was composed mainly of papillary structures with low-grade atypical cells positive for CKAE1/AE3 and CK18. This categorization led to the final diagnosis of PTPR. The patient underwent adjuvant radiotherapy, which vastly improved his neurologic condition and resulted in significant tumor regression.

Conclusions: This case exemplifies that PTPRs can perfectly mimic pineocytomas and simple staining for cytokeratins may warrant correct diagnosis and better treatment.

Keywords: Cytokeratin; PTPR; Papillary tumor of the pineal region; Pathology; Pineocytoma; Radiotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Brain Neoplasms / metabolism
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Diagnosis, Differential
  • Humans
  • Male
  • Neoplasms, Neuroepithelial / metabolism
  • Neoplasms, Neuroepithelial / pathology
  • Neoplasms, Neuroepithelial / therapy*
  • Pineal Gland*