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Pineal Region Tumors: Surgery Perspective

  • Alfred T. Ogden
  • Jeffrey N. Bruce

Abstract

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.

Keywords

Germ Cell Tumor Stereotactic Radiosurgery Stereotactic Biopsy Pineal Region Pineal Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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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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