Pinealoma is a tumor of the pineal gland in the brain that can cause symptoms such as headache, vomiting, and eye movement problems. Diagnosis is made through imaging studies, and treatment involves surgical removal of the tumor. Pinealomas can cause Parinaud’s syndrome and other visual disturbances.
A pinealoma is a tumor of the pineal gland, which is a small structure located in the brain that plays a role in regulating sleep and awakening. Symptoms of this tumor can include headache, vomiting, and the inability to move your eyes up and down. Diagnosis is usually made based on imaging studies. Treatment usually consists of surgical removal of the tumor.
Pinealomas are caused by the disordered growth and replication of cells located in the pineal gland. There are three types of pinealomas, including pineocytoma, atypical pineocytoma, and pineoblastoma. Sometimes these tumors are malignant, meaning they have the ability to grow and invade other parts of the body. Other tumors that originated from other cell types can also be found in the pineal gland, including gliomas and germinomas.
The symptoms of having a pinealoma can vary depending on the size and location of the tumor. Patients may present with nonspecific symptoms such as headache, nausea, and vomiting. If the tumor becomes so large that it disturbs the normal function of the pineal gland, patients may experience insomnia due to disruptions in their circadian rhythms. Sometimes tumors can block the flow of cerebrospinal fluid (CSF) out of the brain and into the spinal cord, causing hydrocephalus, a condition in which too much CSF builds up can cause pressure to rise within the brain, causing several symptoms .
Classically, having a pinealoma is associated with Parinaud’s syndrome. Patients with this syndrome are unable to move their eyes up and down. The syndrome develops because the pineal gland is located near a region of the brain that coordinates the up and down movement of the eyes. Destruction of this region by a tumor originating in the pineal gland can cause this visual disturbance.
The diagnosis of pinealoma can be prompted by a patient’s symptoms, particularly if they develop Parinaud’s syndrome. However, imaging studies are needed to confirm the diagnosis. Typically, a magnetic resonance imaging (MRI) of the brain provides the most detail about the pineal region and doctors or other health care professionals to arrive at the appropriate diagnosis. Other imaging modalities, such as computed tomography (CT), can also provide important details about the growth.
Treatment of a pinealoma involves surgical removal. Because tumors are typically small, their removal requires the use of microscopes to allow neurosurgeons to remove only the abnormal tissue and not remove the normal brain tissue which is important for optimal brain function. After the tumor is removed, the tissue can be examined by a pathologist under a microscope to determine which types of cells were responsible for the tumor. Other options for treatment after surgery may include radiation and chemotherapy.
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