Oligodendroglioma of the pineal region

Case report

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✓ The authors describe an oligodendroglioma of the pineal region in a 59-year-old woman. The patient presented with intermittent confusion, memory disturbance, and headache associated with a cystic pineal region mass demonstrated on magnetic resonance imaging. Gross-total resection was performed via a suboccipital supratentorial approach. Pathological and genetic evaluation showed the tumor to be an anaplastic oligodendroglioma. Although the spectrum of tumors arising within the region of the pineal gland is broad, to the authors’ knowledge this is the first report of an oligodendroglioma occurring in this area.

Abbreviations used in this paper: FISH = fluorescence in situ hybridization; MR = magnetic resonance.

Article Information

Address reprint requests to: Sunit Das, M.D., Ph.D., Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 North St. Clair Street, Suite 2210, Chicago, Illinois 60611. email: s-das@md.northwestern.edu.

© AANS, except where prohibited by US copyright law.

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Figures

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    Preoperative Gd-enhanced T1-weighted MR images demonstrating a heterogeneously enhancing mass extending from the pineal gland into the base of the third ventricle. The internal cerebral veins and the vein of Galen appear to define the dorsal aspect of the lesion. The lesion is centered in the midline, extending laterally above the tentorium (as demonstrated on coronal images, not shown here). Mild ventriculomegaly is present.

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    Photomicrographs of sections cut from different regions of the tumor. A: Section showing tumor infiltration into normal pineal gland tissue. B: Magnified image showing multiple mitotic figures. C: Densely cellular region composed of small cells with generally round nuclei, frequent mitoses, and microvascular proliferation. D: Myxoid region containing numerous cells with intensely eosinophilic cytoplasm reminiscent of microgemistocytes. H & E, original magnifications × 40 (A and D), × 100 (B), and × 20 (C).

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    Gadolinium-enhanced MR image obtained on Day 1 postoperatively, demonstrating gross-total tumor resection.

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