| Pinealoma | |
|---|---|
 | |
| Pineocytoma | |
| Specialty | Oncology |
| Treatment | Surgical resection, radiation therapy |
Apinealoma is a tumor of thepineal gland, a part of the brain that producesmelatonin. If a pinealoma destroys the cells of the pineal gland in a child, it can causeprecocious puberty.
The pineal gland produces the hormonemelatonin which plays a role in regulatingcircadian rhythms. A pinealoma may disrupt production of this hormone, andinsomnia may result.[citation needed]
Frequently, paralysis of upward gaze along with several ocular findings such as convergence retraction nystagmus and eyelid retraction also known asCollier's sign and Light Near Dissociation (pupil accommodates but doesn't react to light) are known collectively asParinaud's syndrome[1] or Dorsal Mid-brain syndrome, are the only physical symptoms seen. This is caused by the compression of thevertical gaze center in themidbraintectum at the level of thesuperior colliculus andcranial nerve III. Work-up usually includes Neuro-imaging as seen on the right.[citation needed]
A pinealoma may cause interruption of hypothalamic inhibiting pathways, sometimes leading to beta-hCG secretion and consequent Leydig's cell stimulation (endocrine syndrome).[citation needed]
Other symptoms may includehydrocephalus,gait disturbances, andprecocious puberty.[citation needed]
Pinealomas can be due to proliferation of primarypineocytes (pineocytomas, pineoblastomas),astrocytes (astrocytoma), orgerm cells (germinoma).[2] Germinomas are the most common tumor in the pineal gland.[citation needed]
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Some pinealomas are treated byradiotherapy, since surgical removal may be impossible due to the location. Radiotherapy can be successful in killing the tumour, and 50% of patients undergoing it survive to old age.
Of the different types of pinealomas, the type with the most favorable prognosis is thepineocytoma.[3]