Description

Pineoblastoma is a type of cancer that begins in the brain, the pineal gland. The pineal gland is located in the center of the brain. The gland produces a hormone called melatonin. Melatonin plays a role in the body's natural sleep-wake cycle.

Pineoblastoma begins as a growth of the cells in the pineal gland. The cells grow rapidly and can invade and destroy healthy body tissue.

Pineoblastoma can occur at any age. But it occurs more often in young children. Pineoblastoma can cause headaches, drowsiness and changes in the way in which the eyes move.

Pineoblastoma can be very difficult to treat. It can spread in the brain and in the fluid that surrounds the brain. This fluid is called the cerebrospinal fluid. Pineoblastoma almost never spreads beyond the central nervous system. Treatment usually involves surgery to remove as much of the cancer as possible. Additional treatments may also be recommended.

Symptoms

Pineoblastoma signs and symptoms include:

  • Changes in behavior.
  • Headaches.
  • The lack of energy.
  • Nausea.
  • Problems with memory and thinking.

Pineoblastoma sometimes causes eye symptoms. This can happen when cancer makes the pressure on the parts of the brain that help with the vision. The ocular symptoms that pineoblastoma causes are sometimes called syndrome of Parinaud. The symptoms of the eye caused by the pineoblastoma include:

  • Blurred vision.
  • Double vision.
  • Problems focus on objects that are near.
  • Problems facing upward.

When to see a doctor

Make an appointment with a doctor or other health care professional if you or your child have symptoms that worry you.

Causes

The cause of the pineoblastomas are often not known. This type of cancer begins as a growth of the cells in the pineal gland. The pineal gland is located in the center of the brain.

Pineoblastoma occurs when the cells in the pineal gland develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes tell cancer cells to grow and multiply quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells form a tumor in the pineal gland. The growth, called a tumor, it may press on the nearby parts of the brain gets bigger. The tumor may also block the flow of fluid in the brain. This makes the pressure that builds up in the interior of the brain.

Risk factors

The risk factors for pineoblastoma include:

  • The young age. Pineoblastoma is most common in children ages 1 to 12 years of age.
  • Inherited cancer in the eye. A genetic disorder called hereditary retinoblastoma increases the risk of pineoblastoma. Hereditary retinoblastoma is run in families. Increases the risk of a type of eye cancer called retinoblastoma and other cancers.

There is no way to prevent the pineoblastoma.

Diagnosis

Pineoblastoma diagnosis often involves imaging tests to take pictures of the brain. Other tests may include the removal of tissue and fluid for the test.

Imaging tests

Imaging tests can find the location and the size of the pineoblastoma. Magnetic resonance imaging, also called magnetic resonance imaging, is often used to diagnose brain tumors. Advanced techniques may also be used. These could include MRI perfusion and magnetic resonance spectroscopy.

Additional tests may include computed tomography scans, also called a CT, and positron emission tomography scans, also called PET.

The removal of a sample of tissue for testing

A biopsy is a procedure to remove a sample of tissue for testing in a lab. You can make with a needle before the surgery. Or the sample can be removed during surgery. The tissue sample will be going to a laboratory for analysis. The results show the cell types and the rapidity with which they are growing.

Extraction of cerebrospinal fluid to the test

A lumbar puncture is a procedure to remove a sample of fluid that surrounds the brain and the spinal cord. This procedure is also called a lumbar puncture. To obtain the liquid, a health care professional inserts a needle between two bones in the lower part of the spine. The health care provider uses a needle to remove some of cerebrospinal fluid around the spinal cord. The fluid is tested to find the pineoblastoma cells. The cerebrospinal fluid can also be obtained during a biopsy to remove tissue from the brain.

Treatment

Pineoblastoma treatment usually involves surgery to remove as much of the cancer as possible. Additional treatments may also be recommended.

Surgery to relieve fluid accumulation in the brain

A pineoblastoma can grow large enough to block the flow of cerebrospinal fluid. This puts pressure on the brain. An operation can redirect the fluid through a drain or a pipe. This helps to relieve the pressure. This procedure can be done at the same time as a biopsy or surgery to remove the pineoblastoma.

The surgery to remove the pineoblastoma

A surgeon of the brain, also called a neurosurgeon, works to remove as much of pineoblastoma as possible. Sometimes all of the cancer cannot be removed. This is due to the pineoblastoma forms close to important structures in the interior of the brain. More treatments after the surgery is usually needed. These treatments target the remaining cells.

Radiation therapy for pineoblastoma

Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams to the brain and the spinal cord. Extra radiation is aimed at the cancer cells.

The radiation is often given to the whole brain and the spinal cord. This is because cancer cells may spread from the brain to other parts of the central nervous system. This treatment is often recommended for adults and children older than 3 years of age.

Chemotherapy for pineoblastoma

Chemotherapy treats the cancer with strong medications. For pineoblastoma, chemotherapy is usually used after surgery or radiation therapy. Sometimes it's used at the same time as radiation therapy. For more pineoblastomas, chemotherapy may be used before surgery. This could reduce the cancer and make it easier to remove.

Radiosurgery for pineoblastoma

Stereotactic radiosurgery focuses multiple beams of radiation at the exact points to kill the cancer cells. Radiosurgery is sometimes used to treat pineoblastoma that comes back after treatment.

Clinical trials

Clinical trials are studies of new treatments. These studies offer the opportunity to try the latest treatment options. The side effects of these treatments may not be known. Ask your child's healthcare provider if your child may be able to participate in a clinical trial.

Preparing for your appointment

Make an appointment with your regular doctor or health care professional if you or your child has any of the symptoms that worry you. If your doctor thinks that you or your child may have pineoblastoma, you may be referred to a specialist. This could be a cancer doctor called an oncologist. You can also see a surgeon who specializes in the operation of the brain, the call of a neurosurgeon.

Appointments can be brief, and being prepared can help. Here is some information that can help you prepare.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you are taking, including the dosage.
  • Questions to ask your doctor.

Have a friend or family member, if possible, to help you remember the information they give you.

For pineoblastoma, some basic questions to ask your doctor include:

  • Do I have cancer?
  • What do I need to remove the cancer?
  • Has the cancer spread?
  • I need more tests?
  • What are my treatment options?
  • What are the potential risks of these treatment options?
  • Do any of the treatments to cure my cancer?
  • I have a copy of my pathology report?
  • How much time can I take to consider my options for treatment?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What would happen if I decide not to have treatment?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you several questions, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of Pineoblastoma