Pineal Tumors

The pineal region is an anatomic location where various intracranial tumors, in particular germ cell tumors and pineal parenchymal tumors, occur. Interestingly, pineal germ cell tumors are detected more frequently in Asian countries, including Japan, while pineal parenchymal tumors are less frequent in Asia than in the United States and Europe. This publication takes advantage of the knowledge and experience of Japanese experts in pineal tumors, with emphasis on epidemiology and pathological diagnosis. A variety of treatment modalities including radiotherapy, radiosurgery, surgical therapy and chemotherapy are also discussed. This valuable book will enhance the knowledge on pineal tumor treatment of not only neurosurgeons and radiation oncologists but also neurologists, neuro-oncologists, pediatricians and neuropathologists interested in pineal region tumors.

The link between the pineal gland and cancer is a rapidly emerging research field due to promising experimental and clinical trials with melatonin. The pineal gland acts as a transducer of environmental light to regulate rhythmic processes, including reproductive function in seasonally breeding animals and the entrainment of circadian rhythms, such as the sleep-wake cycle, in man. This book elucidates the physiological significance of the pineal gland and surveys phenomena and mechanisms of pineal - tumor interaction at the neuroendocrine, neuroimmune, neural, and molecular levels. Yet unidentified low-molecular-weight pineal substances with tumor-inhibiting capacity, a possible involvement of melatonin in electromagnetic field effects on cancer, and the oncotherapeutic potential of melatonin are also addressed. The encouraging results should incite further research to elucidate the exact nature of the link between the pineal gland and cancer for the benefit of patients.

Neurosurgical lesions of the pineal region are extremely rare, accounting for roughly 1% of the total number of neurosurgical expansive lesions in modern practice. This book offers an up-to-date review of the relevant literature, combined with the personal perspectives of some highly experienced figures in the field. The book is divided into two main parts, the first of which offers an overview of the pineal region from an anatomic, pathologic, imaging and therapeutic perspective. Special attention is given to surgical approaches to pineal region lesions. Microsurgical techniques are presented, together with detailed indications regarding specific locations of these lesions, specific complications, and controversial aspects concerning some of the approaches. A dedicated chapter addresses endoscopic techniques, their indications and limitations. Adjuvant therapies are also discussed, along with their particular indications and debated aspects. In turn, the chapters in the second part cover specific lesions such as pineal region tumors, vascular lesions, and cystic and cyst-like lesions. Regarding pineal region tumors, the most frequent pathologies are presented in the most comprehensive and practical manner possible, with special attention to the appropriate therapeutic management for each type. Further, there is a dedicated chapter on pineal region cysts. Given its depth of content, the book will allow neurosurgeons and specialists to greatly expand their understanding of pineal region lesions in daily clinical practice.

Guest Editors Jeffrey Bruce and Andrew Parsa explore Pinneal Region Tumors in this issue of Neurosurgery Clinics. Topics concentrate on areas such as pathology, radiographic features, open surgical approaches, endoscopic surgical approaches, clinical outcomes after treatment of pineocytoma, clinical outcomes after treatment of pineoblastoma, clinical outcomes after treatment of germ cell tumors, pineal cysts: radiographic criteria and clinical management, opthamologic signs and symptoms associated with pineal region tumors, history of pineal region tumor surgery and management, and radiation treatment algorithms.

Adding to a vitally important cycle of publications covering the latest research developments in our understanding of neoplasms affecting the human central nervous system, this edition focuses on numerous aspects of pineal, pituitary, and spinal tumors. As with the previous volumes in the series, this latest work addresses a central imperative in cancer research—the need to standardize classifications, written definitions and investigative guidelines in order to achieve a measure of shared objectivity among academics engaged in one of the most important medical endeavors of our era. It brings together the very latest work by oncologists, neurosurgeons, physicians, research scientists, and pathologists, providing the medical community with a wealth of data and results that, taken together, will advance the cause of cancer research. The volume synthesizes work on diagnosis, drug development, and therapeutic approaches that are typically scattered in a variety of journals and books. It features promising recent work in applying molecular genetics to clinical practice and evidence-based therapy, covering molecular profiling of tumors as well as a number of surgical treatments such as resection and radiosurgery. Together with its counterpart publications, it represents a much-needed central resource that will inform and guide future research efforts.