Spontaneous Regression of Pineal Lesions

Ghost Tumor or Pineal Apoplexy?

Pier Paolo Mattogno, Paolo Frassanito, Luca Massimi, Gianpiero Tamburrini, Mariangela Novello, Libero Lauriola, Massimo Caldarelli

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Pineal apoplexy (either hemorrhagic or ischemic) may complicate the course of a tumor at this site. This event usually is characterized by an acute clinical onset and requires emergency surgical management whereas the regression of the lesion is a much rarer outcome. Material and Methods Three cases of pineal vanishing tumors in the pediatric population are reported and the pertinent literature is reviewed. Results In one case, radiologic findings were consistent with a diagnosis of pineal cyst, which became symptomatic after a spontaneous hemorrhage. This event may also explain its regression after the treatment of associated hydrocephalus. In the remaining 2 cases, neuroimaging examinations disclosed a solid tumor. One of them regressed after a surgical biopsy, probably because of an ischemic evolution, whereas the last one disappeared without any medical or surgical manipulation. Neither hemorrhage nor ischemia were noticed, thus the mechanism of regression remains controversial. Conclusions Vanishing tumors of the pineal region may occur in different circumstances, resulting from absence of any medical and surgical action to minor manipulation of the tumor to obtain a biopsy. This variety may reflect different underlying mechanisms, leading to hemorrhagic or ischemic change of the tumor and its subsequent regression, although radiological imaging may fail to document hemorrhage or ischemia.

Original languageEnglish
Pages (from-to)64-69
Number of pages6
JournalWorld Neurosurgery
Volume88
DOIs
Publication statusPublished - 2016

Fingerprint

Pinealoma
Stroke
Hemorrhage
Neoplasms
Ischemia
Biopsy
Hydrocephalus
Neuroimaging
Cysts
Emergencies
Pediatrics
Population

Keywords

  • Key words Ghost tumor
  • Pineal apoplexy
  • Pineal cyst
  • Pineal gland
  • Pineal gland degeneration
  • Vanishing tumor

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Mattogno, P. P., Frassanito, P., Massimi, L., Tamburrini, G., Novello, M., Lauriola, L., & Caldarelli, M. (2016). Spontaneous Regression of Pineal Lesions: Ghost Tumor or Pineal Apoplexy? World Neurosurgery, 88, 64-69. https://doi.org/10.1016/j.wneu.2015.12.080

Spontaneous Regression of Pineal Lesions : Ghost Tumor or Pineal Apoplexy? / Mattogno, Pier Paolo; Frassanito, Paolo; Massimi, Luca; Tamburrini, Gianpiero; Novello, Mariangela; Lauriola, Libero; Caldarelli, Massimo.

In: World Neurosurgery, Vol. 88, 2016, p. 64-69.

Research output: Contribution to journalArticle

Mattogno, PP, Frassanito, P, Massimi, L, Tamburrini, G, Novello, M, Lauriola, L & Caldarelli, M 2016, 'Spontaneous Regression of Pineal Lesions: Ghost Tumor or Pineal Apoplexy?', World Neurosurgery, vol. 88, pp. 64-69. https://doi.org/10.1016/j.wneu.2015.12.080
Mattogno PP, Frassanito P, Massimi L, Tamburrini G, Novello M, Lauriola L et al. Spontaneous Regression of Pineal Lesions: Ghost Tumor or Pineal Apoplexy? World Neurosurgery. 2016;88:64-69. https://doi.org/10.1016/j.wneu.2015.12.080
Mattogno, Pier Paolo ; Frassanito, Paolo ; Massimi, Luca ; Tamburrini, Gianpiero ; Novello, Mariangela ; Lauriola, Libero ; Caldarelli, Massimo. / Spontaneous Regression of Pineal Lesions : Ghost Tumor or Pineal Apoplexy?. In: World Neurosurgery. 2016 ; Vol. 88. pp. 64-69.
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AB - Background Pineal apoplexy (either hemorrhagic or ischemic) may complicate the course of a tumor at this site. This event usually is characterized by an acute clinical onset and requires emergency surgical management whereas the regression of the lesion is a much rarer outcome. Material and Methods Three cases of pineal vanishing tumors in the pediatric population are reported and the pertinent literature is reviewed. Results In one case, radiologic findings were consistent with a diagnosis of pineal cyst, which became symptomatic after a spontaneous hemorrhage. This event may also explain its regression after the treatment of associated hydrocephalus. In the remaining 2 cases, neuroimaging examinations disclosed a solid tumor. One of them regressed after a surgical biopsy, probably because of an ischemic evolution, whereas the last one disappeared without any medical or surgical manipulation. Neither hemorrhage nor ischemia were noticed, thus the mechanism of regression remains controversial. Conclusions Vanishing tumors of the pineal region may occur in different circumstances, resulting from absence of any medical and surgical action to minor manipulation of the tumor to obtain a biopsy. This variety may reflect different underlying mechanisms, leading to hemorrhagic or ischemic change of the tumor and its subsequent regression, although radiological imaging may fail to document hemorrhage or ischemia.

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