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Case Reports
. 2023 Feb 8;85(3):451-455.
doi: 10.1097/MS9.0000000000000147. eCollection 2023 Mar.

Large pineal parenchymal tumor of intermediate differentiation causing compression with resultant obstructive hydrocephalus: a case report

Oadi N Shrateh  1 , Afnan W M Jobran  1 , Haneen Owienah  2 , Thaer Sweileh  2 , Mohand Abulihya  3 , Nadeem Shahin  4 , Yazan Atawnah  4 , Abdalwahab Kharousha  4 , Hadi Dababseh  4 , Sami Hussein  4   5
Affiliations
Case Reports

Large pineal parenchymal tumor of intermediate differentiation causing compression with resultant obstructive hydrocephalus: a case report

Oadi N Shrateh et al. Ann Med Surg (Lond). .

Abstract

The epithalamus region contains the tiny, functionally endocrine pineal gland, which has the shape of a pinecone. Less than 1% of adult primary intracranial malignancies are pineal parenchymal tumors, which are incredibly uncommon brain tumors. A rare variety of pineal parenchymal tumors are those with intermediate differentiation. These tumors, whose namesake refers to a malignant pineal parenchymal tumor, are intermediate between pineoblastomas and pineocytomas (a benign pineal parenchymal tumor).

Case presentation: A female patient, age 13, who had been experiencing terrible headaches on and off for a month, went to the emergency room. Along with the headache, she experienced nausea, vomiting, dizziness, and blurred eyesight. A nonenhanced computed tomography scan was used for the initial brain neuroimaging, which showed a hypodense mass posterior to the midbrain and superior to the cerebellum. A heterogeneous bulk was visible on MRI.

Clinical outcome: The headache, vertigo, visual disturbance, nausea, and vomiting have all improved, according to the patient. Both postoperative MRIs with and without contrast revealed the resolution of the obstructive hydrocephalus and the absence of any residual enhancing mass. The patient was followed up for 2 months without any complications or adverse events.

Conclusion: One should carefully investigate a headache as the early symptom of many illnesses and rule out any other potential causes. This would therefore enable us to create a management structure for such a very unusual malignancy.

Keywords: brain neoplasms; case report; compression; hydrocephalus; pineal gland; pineal parenchymal tumor.

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Conflict of interest statement

There are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
(A) Axial nonenhanced computed tomography scan showing a hypodense mass; (B) T1 sequence axial MRI; (C) FLAIR (fluid-attenuated inversion recovery) sequence axial MRI; (D) T2 sequence axial MRI; (E) FIESTA (fast imaging employing steady-state acquisition) sequence sagittal MRI; (F) FLAIR sequence sagittal MRI. CSF, cerebrospinal fluid.
Figure 2
Figure 2
(A, B) Hematoxyline and eosin stains; (C) synaptophysin immunostain; (D) KI67 immunostain.
See this image and copyright information in PMC

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