A pinealoma is a tumor of the pineal gland, which is a small structure located in the brain that plays a role in regulating sleeping and awakening. Symptoms of this tumor can include headache, vomiting, and an inability to move the eyes upwards and downwards. Diagnosis is typically made based on performing imaging studies. Treatment generally consists of surgically removing the tumor.
Pinealomas are caused by the unregulated growth and replication of cells located in the pineal gland. There are three types of pinealomas, including the pineocytoma, atypical pineocytoma, and pineoblastoma. Sometimes these tumors are malignant, meaning they have the ability to grow and invade into other parts of the body. Other tumors that have originated from other types of cells can also be found in the pineal gland, including gliomas and germinomas.
Symptoms of having a pinealoma can vary depending on the size and location of the tumor. Patients can have nonspecific symptoms such as headaches, nausea, and vomiting. If the tumor grows so large that it disturbs the normal function of the pineal gland, patients can suffer from insomnia due to disruptions in their circadian rhythms. Sometimes the tumors can block the flow of cerebrospinal fluid (CSF) from the brain and into the spinal cord, causing hydrocephalus, a condition in which excessive accumulation of CSF can cause an increased pressure within the brain, resulting in a number of different symptoms.
Classically, having a pinealoma is associated with Parinaud’s syndrome. Patients with this syndrome are unable to move their eyes up and down. The syndrome develops because the pineal gland is located near a region of the brain that coordinates the upward and downward movement of the eyes. Destruction of this region by a tumor originating in the pineal gland can cause this visual disturbance.
Diagnosis of a pinealoma can be suggested by a patient’s symptoms, particularly if they develop Parinaud’s syndrome. Imaging studies, however, are required to confirm the diagnosis. Typically, a magnetic resonance imaging (MRI) scan of the brain provides the most details about the pineal region, and doctors or other health care professionals to come to the appropriate diagnosis. Other imaging modalities, such as computed tomography (CT) scanning, can also provide important details about the growth.
Treatment of a pinealoma involves surgical removal. Since the tumors are typically small, removing them requires use the use of microscopes to allow neurosurgeons to remove only the abnormal tissue and not remove normal brain tissue that is important for optimal brain function. After removing the tumor, the tissue can be examined by a pathologist under a microscope to determine what types of cells were responsible for the tumor. Other options for treatment after surgery can include radiation and chemotherapy.