NONRESECTIVE TREATMENT OF PINEALOBLASTOMA - A CASE-REPORT

BACKGROUND Stereotactic biopsy followed by cytoreductive surgery and/o r radiation are the standard treatment for pineoblastoma. We are repor ting a patient with a relatively large pineoblastoma, who was treated with a combination of nonresective treatment modalities. METHOD The pa tient is a 20-year-old woman who presented with signs and symptoms of raised intracranial pressure. Magnetic resonance imaging (MRI) showed a large tumor in the pineal region and hydrocephalus. She was emergent ly treated by placement of a ventriculoperitoneal shunt. Three days la ter she underwent a stereotactic biopsy, which showed the tumor to be pineoblastoma. She was then further treated with the following treatme nt modalities: permanent implantation of high activity I-125 seeds, ex ternal radiation, and chemotherapy. RESULTS At 10 months' follow-up, M RI showed complete disappearance of the tumor. At 18 months' follow-up , the patient is asymptomatic, neurologically intact, and her MRI scan s show no evidence of intracranial or intraspinal tumor. CONCLUSIONS T hough the follow-up is relatively short, the results of the nonresecti ve approach in this patient have been excellent.