SNO-EANO-EURACAN consensus on management of pineal parenchymal tumors

Anthony P Y Liu; Bryan K Li; Alexandre Vasiljevic; Michael C Dewan; Benita Tamrazi; Birgit Ertl-Wagner; Jordan R Hansford; Elke Pfaff; Martin Mynarek; Ho-Keung Ng; Derek S Tsang; Nicholas G Gottardo; Amar Gajjar; Eric Bouffet; Christelle Dufour; Barry Pizer; David Schiff; Michael D Jenkinson; Giuseppe Lombardi; Patrick Y Wen; Martin J van den Bent; Annie Huang

doi:10.1093/neuonc/noae128

SNO-EANO-EURACAN consensus on management of pineal parenchymal tumors

Neuro Oncol. 2024 Dec 5;26(12):2159-2173. doi: 10.1093/neuonc/noae128.

Authors

Anthony P Y Liu^{1

2}, Bryan K Li^{3

4}, Alexandre Vasiljevic^{5

6}, Michael C Dewan⁷, Benita Tamrazi⁸, Birgit Ertl-Wagner^{9

10

11}, Jordan R Hansford¹², Elke Pfaff^{13

14

15}, Martin Mynarek^{16

17}, Ho-Keung Ng¹⁸, Derek S Tsang¹⁹, Nicholas G Gottardo²⁰, Amar Gajjar²¹, Eric Bouffet², Christelle Dufour^{22

23}, Barry Pizer²⁴, David Schiff²⁵, Michael D Jenkinson^{26

27}, Giuseppe Lombardi²⁸, Patrick Y Wen²⁹, Martin J van den Bent³⁰, Annie Huang^{2

3

31

32}

Affiliations

¹ Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
² Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
³ Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁴ Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ Service D'Anatomie Et Cytologie Pathologiques, CHU de Lyon, Lyon, France.
⁶ Faculté de Médecine Lyon Est, Université Claude Bernard, Lyon, France.
⁷ Division of Pediatric Neurological Surgery, Vanderbilt University Medical Center, Tennessee, USA.
⁸ Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California, USA.
⁹ Division of Neuroradiology, Department of Diagnostic & Interventional Neuroradiology, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹⁰ Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
¹¹ Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
¹² Michael Rice Centre for Hematology and Oncology, Women's and Children's Hospital; South Australia Health and Medical Research Institute; South Australia Immunogenomics Cancer Institute, University of Adelaide, Adelaide, South Australia, Australia.
¹³ Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany.
¹⁴ Pediatric Glioma Research Group (B360), German Cancer Research Center (DKFZ), Heidelberg, Germany.
¹⁵ Division of Pediatric Glioma Research, Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
¹⁶ Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁷ Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁸ Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
¹⁹ Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
²⁰ Department of Pediatric & Adolescent Oncology and Haematology, Perth Children's Hospital and Brain Tumor Research Program, Telethon Kids Cancer Centre, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
²¹ Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
²² Department of Pediatric and Adolescent Oncology, Gustave Roussy, France.
²³ INSERM, Molecular Predictors and New Targets in Oncology, Paris-Saclay University, Villejuif, France.
²⁴ School of Life Sciences, University of Liverpool, Liverpool, UK.
²⁵ Division of Neuro-Oncology, Department of Neurology, University of Virginia, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
²⁶ Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK.
²⁷ Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK.
²⁸ Department of Medical Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy.
²⁹ Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
³⁰ The Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr molewaterplein 40, Rotterdam, The Netherlands.
³¹ Arthur and Sonia Labatt Brain Tumour Research Centre, Hospital for Sick Children, Toronto, Ontario, Canada.
³² Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

PMID: 39073785
PMCID: PMC11630543 (available on 2025-07-29)
DOI: 10.1093/neuonc/noae128

Abstract

Pineal parenchymal tumors are rare neoplasms for which evidence-based treatment recommendations are lacking. These tumors vary in biology, clinical characteristics, and prognosis, requiring treatment that ranges from surgical resection alone to intensive multimodal antineoplastic therapy. Recently, international collaborative studies have shed light on the genomic landscape of these tumors, leading to refinement in molecular-based disease classification in the 5th edition of the World Health Organization (WHO) classification of tumors of the central nervous system. In this review, we summarize the literature on diagnostic and therapeutic approaches, and suggest pragmatic recommendations for the clinical management of patients presenting with intrinsic pineal region masses including parenchymal tumors (pineocytoma, pineal parenchymal tumor of intermediate differentiation, and pineoblastoma), pineal cyst, and papillary tumors of the pineal region.

Keywords: clinical treatment guidelines; papillary tumor of pineal region; pineal cyst; pineal parenchymal tumors; risk-stratification.

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Publication types

Review

MeSH terms

Brain Neoplasms* / diagnosis
Brain Neoplasms* / genetics
Brain Neoplasms* / pathology
Brain Neoplasms* / therapy
Consensus
Disease Management
Humans
Pineal Gland* / pathology
Pinealoma* / diagnosis
Pinealoma* / pathology
Pinealoma* / therapy

Abstract

Publication types

MeSH terms

Grants and funding