Discussion of diagnosis and therapy strategy for pineal region tumors

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Objective To define the optimal diagnosis and theraputic strategy of pineal region tumors.Method Clinical materials of 154 cases with pineal region tumors were analyzed retrospectively.Results The patients with pineal region tumors often complained with increased intracranial pressure and ocular movement deficiency.The procedure of diagnosis was imaging checking included CT and MRI,tumor mark testing.23 cases which were essential exact diagnosed or high doubt germinomas were choosed to direct radiotherapy or radiotherapy after biopsy.All the tumors disappeared during the follow up time.5 years survival rate was 88.9%.Other 131 cases were chosen for operation treatment.Total removal were achieved in 124 cases and subtotal were achieved in 7 cases.The 5 years survival rate was 84.4%.The operation pathological result included 60 germ cell tumors, 17 pineal parenchymal tumors, 27 neural epithelium tumors and 27 other tumors.Conclusions Pineal region tumors are often combined with hydrocephalus.There was some characteristic feature in the imaging appearance.The cases should be chosen to direct radiotherapy and chemotherapy if was diagnosed germinomas, and be choosed to radiotherapy after biopsy or experimental radiotherapy if was high doubt germinomas.The cases which unable determined germionmas should be choosed microsurgery and assist radiotherapy and chemotherapy postoperation.Hydrocephalus should be treated in consideration during the procedure of tumor treatment. Key words: Pinealoma; Diagnosis; Therapy; Strategy