Pineal Region Tumors
Pineal Region Tumors
The pineal gland is a small endocrine organ located deep in the center of the brain, between the two cerebral hemispheres, near the tectal plate and third ventricle. It is responsible for regulating the sleep-wake cycle (melatonin production). Tumors arising from this region are known as pineal region tumors. Though rare, they are more common in children and adolescents than in adults. In the pediatric population of Bangladesh, pineal region tumors often present late and misdiagnosed, largely due to lack of awareness, poor access to neuroimaging, and shortage of specialized pediatric neurosurgeons. However, with proper diagnosis and surgical care, outcomes can be significantly improved. 𧬠Types of Pediatric Pineal Region Tumors Pineal region tumors in children can be benign or malignant, and include a wide variety of tumor types: Germinomas β Most common malignant tumor in the pineal region; highly radiosensitive Teratomas β Can be mature (benign) or immature/malignant Pineoblastoma β Highly aggressive, fast-growing malignant tumor Pineocytoma β Slow-growing benign tumor Atypical Teratoid/Rhabdoid Tumor (ATRT) β Rare and aggressive tumor seen in young children Gliomas and tectal plate tumors β Arising from adjacent brain tissue Metastatic lesions β Extremely rare in children, but possible Each tumor type has distinct behavior and treatment protocols, making early and accurate diagnosis vital. π Signs and Symptoms of Pineal Region Tumors Because of their deep location, pineal region tumors often obstruct cerebrospinal fluid (CSF) flow, leading to hydrocephalus and increased intracranial pressure. Common symptoms include: Headache, often worse in the morning Vomiting without nausea Double vision or inability to look upward (Parinaudβs syndrome) Drowsiness, confusion, or altered consciousness Balance issues or unsteady walking Seizures (less common) Endocrine abnormalities (especially with germ cell tumors) In Bangladesh, these symptoms are frequently misattributed to viral illness, migraines, or behavioral issues, delaying diagnosis. π§ͺ Diagnostic Approach Proper diagnosis of pineal region tumors requires neuroimaging, hormonal testing, and sometimes tumor markers in CSF or blood. Diagnostic Workup Includes: MRI Brain with Contrast β Best for identifying tumor size, spread, and relationship with ventricles CT Scan β May show calcifications or hemorrhage Tumor markers: AFP (Alpha-fetoprotein) Ξ²-HCG (Beta Human Chorionic Gonadotropin) Helps differentiate between germ cell tumors and other types CSF cytology and marker analysis β In selected cases Visual field and neurological exams Endocrine evaluation β For hormonal imbalances These evaluations are now accessible in Dhaka at NINS and Bangladesh Paediatric Neurocare Centre, where Dr. Md. Nafaur Rahman leads a coordinated diagnostic and treatment approach. π οΈ Surgical Management of Pineal Tumors Surgery plays a key role in both diagnosis and treatment. The main goals are to: Obtain tissue biopsy for accurate diagnosis Resect the tumor (if safe and feasible) Relieve hydrocephalus by restoring CSF flow Surgical Techniques: Endoscopic Third Ventriculostomy (ETV) β Minimally invasive procedure to relieve hydrocephalus Endoscopic or stereotactic biopsy β For diagnosis of deep-seated tumors Microsurgical resection through: Occipital transtentorial approach Supracerebellar infratentorial approach Shunt surgery β In cases with persistent hydrocephalus βPineal region tumors are surgically challenging due to their deep location and proximity to vital brain structures. But with experience, modern tools, and precise planning, safe surgery is now possible in Bangladesh.β β Dr. Md. Nafaur Rahman 𧬠Multimodal Treatment for Malignant Tumors For malignant pineal tumors like germinoma, pineoblastoma, or ATRT, surgery is only the first step. Treatment often includes: Radiotherapy β Especially effective for germinomas Chemotherapy β For aggressive or residual tumors Targeted hormonal support and rehabilitation Dr. Nafaur Rahman works closely with pediatric oncologists and radiation oncologists to provide personalized, protocol-based care for each child. π Prognosis and Long-Term Care Benign tumors (e.g., pineocytoma, mature teratoma) can often be cured with surgery alone Germinomas have an excellent prognosis with combined therapy Aggressive tumors (pineoblastoma, ATRT) require intensive therapy and close follow-up Hydrocephalus and visual issues may persist and need long-term care Children need lifelong monitoring, including: Regular MRIs Hormonal assessments Neuro-rehabilitation Psychological and academic support π§π© Pediatric Pineal Tumors in Bangladesh β A Growing Concern Bangladeshβs young population and improving diagnostic access mean that more children are being identified with pineal tumors. However, the challenges remain: Delayed diagnosis due to poor awareness Limited pediatric neurosurgical services outside Dhaka Misinterpretation of symptoms by general physicians Financial barriers to MRI and surgery Dr. Md. Nafaur Rahman is actively working to improve access, educate general practitioners, and deliver state-of-the-art care to all Bangladeshi children, regardless of geography or background. π¨ββοΈ Why Choose Dr. Md. Nafaur Rahman? π Expert in deep-seated pediatric brain tumor surgery π₯ Leads a dedicated pediatric neurosurgery unit at NINS and BP Neurocare Centre π¬ Uses intraoperative navigation, endoscopy, and advanced monitoring π§ Offers personalized care with a multidisciplinary team π§π© One of Bangladeshβs most trusted names in pediatric neurosurgery π Contact for Pineal Region Tumor Treatment Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre π± For Serial/Appointment: 01912988182 | 01607033535 π Website: www.neurosurgeonnafaur.com
Common Pineal Region Tumors
