Neuroendocrine, immunohistochemical, and ultrastructural study of pineal region tumors

Nadia Grimoldi, Giustino Tomei, Bojidar Stankov, Valeria Lucini, Battistina Masini, Valentina Caputo, M. Luisa Repetti, Giulia Lazzarini, S. M. Gaini, Claudio Lucarini, Franco Fraschini, Roberto Villani

Research output: Contribution to journalArticlepeer-review


Thirteen patients with tumors in the pineal region were submitted to pre- and post-operative blood sampling (08:00, 14:00, 20:00 and 02:00 hr) for three or four consecutive days. A single cerebrospinal fluid (CSF) sample was collected at surgery and melatonin levels determined. In all patients, serum and CSF beta subunit of human chorionic gonadotrophin (βHCG), carcino embryonic antigen (CEA), and alpha-fetoprotein (AFP) levels were measured. Histology revealed four pineocytomas, one pineoblastoma, four germinomas, one immature teratoma, one pilocytic astrocytoma, one lymphoma, and one meningioma. Serum and CSF levels of serological biomarkers were normal, except for one of the germinoma cases. In most patients, alteration either in the circadian rhythm or in the melatonin concentration was observed before surgery. In benign neoplasms the circadian rhythm was conserved. In pineoblastoma, lymphoma, and three out of four germinomas, melatonin concentrations were undetectable. In one case of germinoma, melatonin levels were high, with the circadian rhythm being abolished. According to conventional histology, all germinomas were similar. Therefore, in a rare case of pineal germinoma with high melatonin levels, the tissue was subjected to an in depth investigation (immunohistochemical and ultrastructural) in order to determine the pathology and the possible differences from the other typical germinomas. Results were compared to those provided from other pineal neoplasms. Electron microscopy examination detected the presence of clusters of intermediate filaments and numerous electrondense granules only in the case of a germinoma producing melatonin.

Original languageEnglish
Pages (from-to)147-158
Number of pages12
JournalJournal of Pineal Research
Issue number3
Publication statusPublished - 1998


  • Germinoma
  • Melatonin
  • Pineal tumors
  • Pinealoma
  • Serological biomarkers

ASJC Scopus subject areas

  • Endocrinology


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