Pineal Region Brain Tumour Treatment Revisited: A Case Report

Abstract

Pineal region tumours may affect only a relatively small subset of neurosurgical patients, but they present enormous surgical challenge to the neurosurgeon due to their inaccessibly deep locations and compounded by the complex surrounding neurovascular structures. We present a case report of a patient who had combination chemoradiation without histological diagnosis but had complete tumour regression. Cyclical combination chemotherapy with cisplatin, etoposide and bleomycin and radiotherapy followed pre- chemoradiation ventriculo-peritoneal shunt insertion for obstructive hydrocephalus. The patient’s clinical condition improved following the ventriculoperitoneal shunt insertion as walking became re-established. Post – chemoradiotherapy cranial CT scan showed complete tumour regression. Tissue diagnosis may allow for precise, targeted management of pineal region tumours. However, in the absence of facilities which enable safe neurosurgery, resorting to the traditional chemo-radiation is still a viable alternative