Five-year Review of Pineal Region Tumors at the Philippine General Hospital

Abstract

Rationale: Pineal region tumors are rare neoplasms with a reportedly higher incidence in Asian countries; however, local Philippine data is lacking. Methods: A retrospective chart review was conducted on all newly diagnosed adult and pediatric patients with pineal region tumors admitted at the Philippine General Hospital between 2011 and 2015. Data about demographic profile, biochemical markers, imaging findings, histopathology, and treatment were collected. Results: Forty-two patients (36 males, 6 females; Sex Ratio = 6:1) were included in the study, with a mean age of 16.5 years. On imaging, solitary pineal area tumors were seen in 34 (81%) patients, while 8 (19%) presented with synchronous tumors in the pineal and suprasellar areas. Hydrocephalus was present in 41 (98%). Tumor marker (serum +/- CSF αFP and βhCG) determination was performed in 33(79%) patients. Thirty-eight (90%) patients underwent surgical intervention for tumor biopsy and/or CSF diversion. Combining the tumor marker levels and histopathology results, there were 20(48%) germ cell tumors, 4(9%) pineal parenchymal tumors, 1(2%) meningioma, 1(2%) epidermoid tumor, and 16(38%) tumors with incomplete diagnosis. Regarding adjuvant treatment, 5 patients underwent chemotherapy, 6 underwent radiotherapy, and 1 patient received both. Follow-up data were available in only 16 patients, with a mean follow-up of 12 months (range: 1-33 months). Conclusion: The demographic profile and histologic subtypes of patients with pineal region tumors in this series were comparable with other series in the literature. However, due to limited resources leading to suboptimal medical care and poor follow-up, a reliable treatment outcome could not be determined. Key words: pineal gland, brain neoplasms, germinoma, biomarkers tumor