Pineal Region Tumors: Surgery Perspective

  • Alfred T. Ogden
  • Jeffrey N. Bruce


Since the seminal articles that described safe and effective approaches to the pineal region in the early 1970s [1], [2], numerous surgical series have established open surgery as a critical tool in the treatment of pineal region lesions [3]–[13]. Although the difficulties and perils of pineal surgery were considered prohibitive during the nascent years of neurosurgery [14]–[16], the advent of the operating microscope, microneurosurgical techniques, magnetic resonance imaging (MRI), and the development of neurologic intensive care as a specialty have all helped to develop pineal region surgery within a reasonable degree of safety. Open surgery is the treatment of choice for benign tumors. Depending on specific histology, open surgery has a variable role in the treatment of malignant tumors and tumors with mixed elements, either as a means of cytoreduction prior to chemotherapy and/or radiation [17], [18] or as the best option to eradicate benign elements in mixed tumors after chemotherapy/radiation [4], [19]. Additionally, through immediate removal of obstructing lesions, open surgery can obviate the need for permanent cerebrospinal fluid (CSF) diversion. Open surgery also offers comprehensive tissue sampling for a group of tumors that can be of mixed histology and are notoriously difficult to diagnose.


Germ Cell Tumor Stereotactic Radiosurgery Stereotactic Biopsy Pineal Region Pineal Tumor 
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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Alfred T. Ogden
    • 1
  • Jeffrey N. Bruce
    • 2
  1. 1.Department of Neurological SurgeryColumbia UniversityNew YorkUSA
  2. 2.Department of NeurosurgeryColumbia University—College of Physicians and SurgeonsNew YorkUSA

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