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https://doi.org/10.21860/medflum2018_207361

Pineal parenchymal tumor of intermediate differentiation – case report

Dora Gašparini orcid.org/0000-0002-0503-9516 ; Medicinski fakultet, Sveučilište u Rijeci, Rijeka
Nives Jonjić ; Zavod za patologiju, Medicinski fakultet, Sveučilište u Rijeci, Rijeka
Dinko Štimac ; Klinika za neurokirurgiju, Klinički bolnički centar Rijeka, Rijeka
Andrea Dekanić ; Zavod za patologiju, Medicinski fakultet, Sveučilište u Rijeci, Rijeka

Abstract

Aim: To report a case of a patient with the pineal parenchymal tumor of intermediate differentiation grade II, with emphasis on histopathological diagnosis of this clinical entity.
Case report: A 30-year-old patient was admitted at the Clinic for Neurosurgery within the Clinical Hospital Centre Rijeka in order to surgically remove a cyst in the pineal region. The only and main symptoms were headaches in the past four years. Magnetic resonance was performed to visualize the pineal cyst. Osteoclastic suboccipital median craniotomy with extirpation of the cyst had been done and the biopsy specimen was sent to the Pathology Department of the Clinical Hospital Centre Rijeka. Histologically, the tissue of the brain was infiltrated by a moderately cellular tumor tissue consisting of diffusely distributed small uniform cells with scarce cytoplasms and with the tendency to form perivascular acellular areas with discrete pineocytomatous rosettes. Nuclei of the tumor cells were oval and monomorphic with an occasional mild polimorphism. Mitotic activity was low and measured less than 0,5%. The biopsy specimen included several smaller foci of calcification without the presence of necrosis. Immunohistochemistry showed strong diffuse positivity for neuron-specific enolase and synaptophysin, which suggests neuroendocrine differentiation. According to the histological findings and immunohistochemistry profile the pineal parenchymal tumor of intermediate differentiation - WHO gradus II has been diagnosed. The patient was feeling well after the operation and had been dismissed for further home treatment.
Conclusions: Only precisely determined histopathological diagnosis will result in adequate choice of therapy and accurate clinical approach to any patient with this type of tumor. Further molecular research needs to be conducted in order to form standardized guidelines which would help in process of confirming the exact diagnosis.

Keywords

brain neoplasms; central nervous system neoplasms; diagnosis; pathology; pinealoma

Hrčak ID:

207361

URI

https://hrcak.srce.hr/207361

Publication date:

1.12.2018.

Article data in other languages: croatian

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