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Page title without namespace (page_title ) | 'Pineoblastoma' |
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Old page wikitext, before the edit (old_wikitext ) | '{{Infobox medical condition (new)
| name = Pineoblastoma
| synonyms = '''Pineoblastoma'''
| image =
| caption =
| pronounce =
| field =
| symptoms =
| complications =
| onset =
| duration =
| types =
| causes =
| risks =
| diagnosis =
| differential =
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| prognosis =
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}}
[[File:Pineoblastoma.jpg|thumb|Pineoblastoma on brain imaging]]
'''Pineoblastoma''' is a malignant [[tumor]] of the [[pineal gland]]. A pineoblastoma is a supratentorial midline [[primitive neuroectodermal tumor]].<ref name=":7">{{Cite web |last=Mayo Clinic Staff |title=Brain Tumor: Pineoblastoma |url=https://www.mayoclinic.org/diseases-conditions/pineoblastoma/cdc-20353269#:~:text=Pineoblastoma%20is%20a%20rare%2C%20aggressive,your%20natural%20sleep%2Dwake%20cycle. |access-date=18 April 2022}}</ref> Pineoblastoma can present at any age, but is most common in young children. They account for 0.001% of all primary CNS neoplasms.<ref name=":0">{{cite journal |vauthors=Sin-Chan P, Li BK, Ho B, Fonseca A, Huang A |date=July 2018 |title=Molecular Classification and Management of Rare Pediatric Embryonal Brain Tumors |journal=Current Oncology Reports |volume=20 |issue=9 |pages=69 |doi=10.1007/s11912-018-0717-7 |pmid=29995179}}</ref>
== Epidemiology ==
Pineoblastomas typically occur at very young ages. One study found the average age of presentation to be 4.3 years, with peaks at age 3 and 8.<ref name=":0" /> Another cites cases to more commonly occur in patients under 2 years of age.<ref name=":1">{{cite journal | vauthors = Tamrazi B, Nelson M, Blüml S | title = Pineal Region Masses in Pediatric Patients | journal = Neuroimaging Clinics of North America | volume = 27 | issue = 1 | pages = 85–97 | date = February 2017 | pmid = 27889025 | doi = 10.1016/j.nic.2016.08.002 }}</ref> Rates of occurrence for males and females are similar, but may be slightly more common in females.<ref name=":1" /><ref name=":0" /> One study found incidence of pineoblastoma to be increased in black patients compared to white patients by around 71%.<ref>{{cite journal | vauthors = Greppin K, Cioffi G, Waite KA, Ostrom QT, Landi D, Takaoka K, Kruchko C, Barnholtz-Sloan JS | display-authors = 6 | title = Epidemiology of pineoblastoma in the United States, 2000-2017 | journal = Neuro-Oncology Practice | volume = 9 | issue = 2 | pages = 149–157 | date = April 2022 | pmid = 35371520 | pmc = 8965073 | doi = 10.1093/nop/npac009 }}</ref> This difference was most apparent in patients aged 5 to 9 years old.
== Pathophysiology ==
The [[pineal gland]] is a small organ in the center of the brain that is responsible for controlling [[melatonin]] secretion.<ref name=":7" /> Several tumors can occur in the area of the pineal gland, with the most aggressive being pineoblastoma. Pineoblastomas arise from embryonal cells in the pineal gland and are rapidly growing. They are considered grade 4 tumors, meaning they are [[Malignancy|malignant]] and may [[Metastasis|metastasize]].<ref>{{Cite web |date=2018-09-17 |title=Pineal Region Tumors Diagnosis and Treatment - NCI |url=https://www.cancer.gov/rare-brain-spine-tumor/tumors/pineal-region-tumors |access-date=2022-10-11 |website=www.cancer.gov |language=en}}</ref> Due to the pineal gland's location at the center of the brain and the rapidly growing nature of this disease, obstruction of CNS fluid is a common symptom.
The exact cause of pineoblastoma is unknown. [[MicroRNA]] dysregulation has been found to be associated with many cases of pineoblastoma, specifically, mutations in [[Dicer|DICER1]] and [[Drosha|DROSHA]] genes.<ref name=":4">{{cite journal | vauthors = Blessing MM, Alexandrescu S | title = Embryonal Tumors of the Central Nervous System: An Update | journal = Surgical Pathology Clinics | volume = 13 | issue = 2 | pages = 235–247 | date = June 2020 | pmid = 32389264 | doi = 10.1016/j.path.2020.01.003 }}</ref> DICER1 germline mutations cause a tumor predisposition syndrome, and should be considered in patients with pineoblastoma.<ref>{{cite book | vauthors = Schultz KA, Stewart DR, Kamihara J, Bauer AJ, Merideth MA, Stratton P, Huryn LA, Harris AK, Doros L, Field A, Carr AG | display-authors = 6 | chapter = DICER1 Tumor Predisposition |date=1993 |url=http://www.ncbi.nlm.nih.gov/books/NBK196157/ |title = GeneReviews® | veditors = Adam MP, Everman DB, Mirzaa GM, Pagon RA |place=Seattle (WA) |publisher=University of Washington, Seattle |pmid=24761742 |access-date=2022-10-11 }}</ref>
Pineoblastoma may occur in patients with hereditary uni- or bilateral [[retinoblastoma]]. When retinoblastoma patients present with pineoblastoma this is characterized as "[[trilateral retinoblastoma]]".<ref name="pmid7900586">{{cite journal | vauthors = Provenzale JM, Weber AL, Klintworth GK, McLendon RE | title = Radiologic-pathologic correlation. Bilateral retinoblastoma with coexistent pinealoblastoma (trilateral retinoblastoma) | journal = AJNR. American Journal of Neuroradiology | volume = 16 | issue = 1 | pages = 157–165 | date = January 1995 | pmid = 7900586 | url = http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=7900586 }}</ref> Up to 5% of patients with hereditary retinoblastoma are at risk of developing trilateral retinoblastoma.<ref name=":6">{{cite journal | vauthors = de Jong MC, Kors WA, de Graaf P, Castelijns JA, Moll AC, Kivelä T | title = The Incidence of Trilateral Retinoblastoma: A Systematic Review and Meta-Analysis | journal = American Journal of Ophthalmology | volume = 160 | issue = 6 | pages = 1116–1126.e5 | date = December 2015 | pmid = 26374932 | doi = 10.1016/j.ajo.2015.09.009 | hdl-access = free | hdl = 10138/223832 }}</ref> This tumor combination is more aggressive than an isolated pineoblastoma.<ref name=":1" /> Prognosis of patients with trilateral retinoblastoma is dismal, only a few patients have survived more than 5 years after diagnosis; all survivors were diagnosed with small tumors in a subclinical stage.<ref name="pmid10561222">{{cite journal | vauthors = Kivelä T | title = Trilateral retinoblastoma: a meta-analysis of hereditary retinoblastoma associated with primary ectopic intracranial retinoblastoma | journal = Journal of Clinical Oncology | volume = 17 | issue = 6 | pages = 1829–1837 | date = June 1999 | pmid = 10561222 | doi = 10.1200/JCO.1999.17.6.1829 }}</ref> Recent advances in (high-dose) chemotherapy treatment regimens and early detection have improved survival of patients with trilateral retinoblastoma to up to 50%.<ref name=":6" />
Additionally, various mutations or deletions in chromosomes 1, 9, 13, 16 and 22 have been associated with pineoblastoma incidence.<ref name=":0" />
== Clinical Features ==
The most common symptoms to occur with pineoblastoma are headache, behavior changes, and cognitive disturbances.<ref>{{Cite web |title=Pineoblastoma - About the Disease - Genetic and Rare Diseases Information Center |url=https://rarediseases.info.nih.gov/diseases/9369/pineoblastoma |access-date=2022-10-06 |website=rarediseases.info.nih.gov |language=en}}</ref> These masses also often cause [[Hydrocephalus|obstructive hydrocephalus]], leading to [[Intracranial pressure|increased intracranial pressure]]. This can result in vision changes and [[Parinaud's syndrome|Parinaud's]] syndrome.<ref name=":0" />
Due to the aggressive nature of the disease, tumor spread at the time of diagnosis is common.<ref name=":3">{{cite journal | vauthors = Amato-Watkins AC, Lammie A, Hayhurst C, Leach P | title = Pineal parenchymal tumours of intermediate differentiation - An evidence-based review of a new pathological entity | journal = British Journal of Neurosurgery | volume = 30 | issue = 1 | pages = 11–15 | date = 2016-01-02 | pmid = 26571134 | doi = 10.3109/02688697.2015.1096912 }}</ref> Pineoblastomas often invades locally, with spread to the head and spine seen in 25-41% of patients.<ref name=":0" /> While CNS spread is relatively common, these tumors rarely cause distant metastases.<ref name=":5">{{Cite web |title=Pineoblastoma |url=https://www.stjude.org/disease/pineoblastoma.html |access-date=2022-10-05 |website=www.stjude.org |language=en}}</ref>
== Diagnosis ==
[[File:Pineoblastoma_HE_x200.jpg|thumb|Histology of pineoblastoma]]
Several imaging methods can be used to diagnosis pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.
Diagnosis also requires CSF sampling via lumbar puncture to assess for cytology and tumor markers.<ref name=":3" />
Biopsy is required for diagnosis. Pineoblastomas appear as high grade, highly cellular, small blue cells histologically. Features of aggressive malignancies can be seen, like high nucleus-to-cytoplasm ration, poorly differentiated cells, [[Mitotic index|high mitotic activity]], and necrosis.<ref name=":3" /><ref name=":0" /> [[Homer Wright pseudorosettes|Homer Wright]], or neuroblastic, and Flexner-Wintersteiner, or retinoblastic, rosettes can also be seen. In contrast to other masses of the pineal gland, pineocytomatous rosettes are not present.<ref name=":3" /> [[Immunohistochemistry]] staining will reveal [[Neuronal lineage marker|neuronal]], [[Glia|glial]], and [[Photoreceptor cell|photoreceptor]] marker positivity. This includes [[synaptophysin]], [[neurofilament]] protein, and [[CRX (gene)|CRX]], a specific pineal or [[Retina|retinal]] marker, positive staining.<ref name=":3" /><ref name=":4" />
== Treatment ==
Initial treatment for pineoblastoma often includes a shunting procedure to redirect accumulated cerebrospinal fluid secondary to obstructive hydrocephalus.<ref name=":7" /> This shunt can help manage increased intracranial pressure and relieve some symptoms. Surgery to remove the tumor is associated with better outcomes, however, this is not always possible due to the proximity of the pineal gland to neurovascular structures.<ref name=":0" /> Complete tumor resection is only seen in about 30% of cases. Following surgery, [[radiation therapy]] to the brain and spinal cord can increase survival.<ref name=":7" /> However, radiation can only safely be used in patients over 3 years old due to the risk of significant neurological impairment. [[Chemotherapy]] treatment can also be used, either before or after surgery; its optimal use is still under investigation.<ref name=":0" />
== Prognosis ==
Pineoblastomas are very aggressive tumors. 5-year survival for patients with pineoblastomas is around 58%.<ref name=":3" /> Prognosis for patients under 5 years old is lower, between 15 and 40%.<ref name=":0" /> Disseminated disease at diagnosis is also associated with worse outcomes. When pineoblastomas occur with retinoblastomas, the prognosis is typically worse, and these patients require more aggressive treatment.<ref name=":1" />
Complete gross tumor resection is associated with improved prognosis, but is difficult and rare to achieve. Radiation therapy after surgery is also linked to improved survival.<ref name=":0" />
== References ==
{{reflist}}
== External links ==
{{Medical resources
| DiseasesDB =
| ICD10 = C75.3
| ICD9 =
| ICDO = 9362/3
| OMIM =
| MedlinePlus =
| eMedicineSubj =
| eMedicineTopic =
| MeshID = D010871
}}
{{Endocrine gland neoplasia}}
[[Category:Endocrine neoplasia]]
[[Category:Brain tumor]]' |
New page wikitext, after the edit (new_wikitext ) | '{{Infobox medical condition (new)
| name = Pineoblastoma
| synonyms = '''Pineoblastoma'''
| image =
| caption =
| pronounce =
| field =
| symptoms =
| complications =
| onset =
| duration =
| types =
| causes =
| risks =
| diagnosis =
| differential =
| prevention =
| treatment =
| medication =
| prognosis =
| frequency =
| deaths =
}}
[[File:Pineoblastoma.jpg|thumb|Pineoblastoma on brain imaging]]
'''Pineoblastoma''' is a malignant [[tumor]] of the [[pineal gland]]. A pineoblastoma is a supratentorial midline [[primitive neuroectodermal tumor]].<ref name=":7">{{Cite web |last=Mayo Clinic Staff |title=Brain Tumor: Pineoblastoma |url=https://www.mayoclinic.org/diseases-conditions/pineoblastoma/cdc-20353269#:~:text=Pineoblastoma%20is%20a%20rare%2C%20aggressive,your%20natural%20sleep%2Dwake%20cycle. |access-date=18 April 2022}}</ref> Pineoblastoma can present at any age, but is most common in young children. They account for 0.001% of all primary CNS neoplasms.<ref name=":0">{{cite journal |vauthors=Sin-Chan P, Li BK, Ho B, Fonseca A, Huang A |date=July 2018 |title=Molecular Classification and Management of Rare Pediatric Embryonal Brain Tumors |journal=Current Oncology Reports |volume=20 |issue=9 |pages=69 |doi=10.1007/s11912-018-0717-7 |pmid=29995179}}</ref>
== Epidemiology ==
Pineoblastomas typically occur at very young ages. One study found the average age of presentation to be 4.3 years, with peaks at age 3 and 8.<ref name=":0" /> Another cites cases to more commonly occur in patients under 2 years of age.<ref name=":1">{{cite journal | vauthors = Tamrazi B, Nelson M, Blüml S | title = Pineal Region Masses in Pediatric Patients | journal = Neuroimaging Clinics of North America | volume = 27 | issue = 1 | pages = 85–97 | date = February 2017 | pmid = 27889025 | doi = 10.1016/j.nic.2016.08.002 }}</ref> Rates of occurrence for males and females are similar, but may be slightly more common in females.<ref name=":1" /><ref name=":0" /> One study found incidence of pineoblastoma to be increased in black patients compared to white patients by around 71%.<ref>{{cite journal | vauthors = Greppin K, Cioffi G, Waite KA, Ostrom QT, Landi D, Takaoka K, Kruchko C, Barnholtz-Sloan JS | display-authors = 6 | title = Epidemiology of pineoblastoma in the United States, 2000-2017 | journal = Neuro-Oncology Practice | volume = 9 | issue = 2 | pages = 149–157 | date = April 2022 | pmid = 35371520 | pmc = 8965073 | doi = 10.1093/nop/npac009 }}</ref> This difference was most apparent in patients aged 5 to 9 years old.
== Pathophysiology ==
The [[pineal gland]] is a small organ in the center of the brain that is responsible for controlling [[melatonin]] secretion.<ref name=":7" /> Several tumors can occur in the area of the pineal gland, with the most aggressive being pineoblastoma. Pineoblastomas arise from embryonal cells in the pineal gland and are rapidly growing. They are considered grade 4 tumors, meaning they are [[Malignancy|malignant]] and may [[Metastasis|metastasize]].<ref>{{Cite web |date=2018-09-17 |title=Pineal Region Tumors Diagnosis and Treatment - NCI |url=https://www.cancer.gov/rare-brain-spine-tumor/tumors/pineal-region-tumors |access-date=2022-10-11 |website=www.cancer.gov |language=en}}</ref> Due to the pineal gland's location at the center of the brain and the rapidly growing nature of this disease, obstruction of CNS fluid is a common symptom.
The exact cause of pineoblastoma is unknown. [[MicroRNA]] dysregulation has been found to be associated with many cases of pineoblastoma, specifically, mutations in [[Dicer|DICER1]] and [[Drosha|DROSHA]] genes.<ref name=":4">{{cite journal | vauthors = Blessing MM, Alexandrescu S | title = Embryonal Tumors of the Central Nervous System: An Update | journal = Surgical Pathology Clinics | volume = 13 | issue = 2 | pages = 235–247 | date = June 2020 | pmid = 32389264 | doi = 10.1016/j.path.2020.01.003 }}</ref> DICER1 germline mutations cause a tumor predisposition syndrome, and should be considered in patients with pineoblastoma.<ref>{{cite book | vauthors = Schultz KA, Stewart DR, Kamihara J, Bauer AJ, Merideth MA, Stratton P, Huryn LA, Harris AK, Doros L, Field A, Carr AG | display-authors = 6 | chapter = DICER1 Tumor Predisposition |date=1993 |url=http://www.ncbi.nlm.nih.gov/books/NBK196157/ |title = GeneReviews® | veditors = Adam MP, Everman DB, Mirzaa GM, Pagon RA |place=Seattle (WA) |publisher=University of Washington, Seattle |pmid=24761742 |access-date=2022-10-11 }}</ref>
Pineoblastoma may occur in patients with hereditary uni- or bilateral [[retinoblastoma]]. When retinoblastoma patients present with pineoblastoma this is characterized as "[[trilateral retinoblastoma]]".<ref name="pmid7900586">{{cite journal | vauthors = Provenzale JM, Weber AL, Klintworth GK, McLendon RE | title = Radiologic-pathologic correlation. Bilateral retinoblastoma with coexistent pinealoblastoma (trilateral retinoblastoma) | journal = AJNR. American Journal of Neuroradiology | volume = 16 | issue = 1 | pages = 157–165 | date = January 1995 | pmid = 7900586 | url = http://www.ajnr.org/cgi/pmidlookup?view=long&pmid=7900586 }}</ref> Up to 5% of patients with hereditary retinoblastoma are at risk of developing trilateral retinoblastoma.<ref name=":6">{{cite journal | vauthors = de Jong MC, Kors WA, de Graaf P, Castelijns JA, Moll AC, Kivelä T | title = The Incidence of Trilateral Retinoblastoma: A Systematic Review and Meta-Analysis | journal = American Journal of Ophthalmology | volume = 160 | issue = 6 | pages = 1116–1126.e5 | date = December 2015 | pmid = 26374932 | doi = 10.1016/j.ajo.2015.09.009 | hdl-access = free | hdl = 10138/223832 }}</ref> This tumor combination is more aggressive than an isolated pineoblastoma.<ref name=":1" /> Prognosis of patients with trilateral retinoblastoma is dismal, only a few patients have survived more than 5 years after diagnosis; all survivors were diagnosed with small tumors in a subclinical stage.<ref name="pmid10561222">{{cite journal | vauthors = Kivelä T | title = Trilateral retinoblastoma: a meta-analysis of hereditary retinoblastoma associated with primary ectopic intracranial retinoblastoma | journal = Journal of Clinical Oncology | volume = 17 | issue = 6 | pages = 1829–1837 | date = June 1999 | pmid = 10561222 | doi = 10.1200/JCO.1999.17.6.1829 }}</ref> Recent advances in (high-dose) chemotherapy treatment regimens and early detection have improved survival of patients with trilateral retinoblastoma to up to 50%.<ref name=":6" />
Additionally, various mutations or deletions in chromosomes 1, 9, 13, 16 and 22 have been associated with pineoblastoma incidence.<ref name=":0" />
== Clinical Features ==
The most common symptoms to occur with pineoblastoma are headache, behavior changes, and cognitive disturbances.<ref>{{Cite web |title=Pineoblastoma - About the Disease - Genetic and Rare Diseases Information Center |url=https://rarediseases.info.nih.gov/diseases/9369/pineoblastoma |access-date=2022-10-06 |website=rarediseases.info.nih.gov |language=en}}</ref> These masses also often cause [[Hydrocephalus|obstructive hydrocephalus]], leading to [[Intracranial pressure|increased intracranial pressure]]. This can result in vision changes and [[Parinaud's syndrome|Parinaud's]] syndrome.<ref name=":0" />
Due to the aggressive nature of the disease, tumor spread at the time of diagnosis is common.<ref name=":3">{{cite journal | vauthors = Amato-Watkins AC, Lammie A, Hayhurst C, Leach P | title = Pineal parenchymal tumours of intermediate differentiation - An evidence-based review of a new pathological entity | journal = British Journal of Neurosurgery | volume = 30 | issue = 1 | pages = 11–15 | date = 2016-01-02 | pmid = 26571134 | doi = 10.3109/02688697.2015.1096912 }}</ref> Pineoblastomas often invades locally, with spread to the head and spine seen in 25-41% of patients.<ref name=":0" /> While CNS spread is relatively common, these tumors rarely cause distant metastases.<ref name=":5">{{Cite web |title=Pineoblastoma |url=https://www.stjude.org/disease/pineoblastoma.html |access-date=2022-10-05 |website=www.stjude.org |language=en}}</ref>
== Diagnosis ==
[[File:Pineoblastoma_HE_x200.jpg|thumb|Histology of pineoblastoma]]
Several imaging methods can be used to diagnose pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.
Diagnosis also requires CSF sampling via lumbar puncture to assess for cytology and tumor markers.<ref name=":3" />
Biopsy is required for diagnosis. Pineoblastomas appear as high grade, highly cellular, small blue cells histologically. Features of aggressive malignancies can be seen, like high nucleus-to-cytoplasm ration, poorly differentiated cells, [[Mitotic index|high mitotic activity]], and necrosis.<ref name=":3" /><ref name=":0" /> [[Homer Wright pseudorosettes|Homer Wright]], or neuroblastic, and Flexner-Wintersteiner, or retinoblastic, rosettes can also be seen. In contrast to other masses of the pineal gland, pineocytomatous rosettes are not present.<ref name=":3" /> [[Immunohistochemistry]] staining will reveal [[Neuronal lineage marker|neuronal]], [[Glia|glial]], and [[Photoreceptor cell|photoreceptor]] marker positivity. This includes [[synaptophysin]], [[neurofilament]] protein, and [[CRX (gene)|CRX]], a specific pineal or [[Retina|retinal]] marker, positive staining.<ref name=":3" /><ref name=":4" />
== Treatment ==
Initial treatment for pineoblastoma often includes a shunting procedure to redirect accumulated cerebrospinal fluid secondary to obstructive hydrocephalus.<ref name=":7" /> This shunt can help manage increased intracranial pressure and relieve some symptoms. Surgery to remove the tumor is associated with better outcomes, however, this is not always possible due to the proximity of the pineal gland to neurovascular structures.<ref name=":0" /> Complete tumor resection is only seen in about 30% of cases. Following surgery, [[radiation therapy]] to the brain and spinal cord can increase survival.<ref name=":7" /> However, radiation can only safely be used in patients over 3 years old due to the risk of significant neurological impairment. [[Chemotherapy]] treatment can also be used, either before or after surgery; its optimal use is still under investigation.<ref name=":0" />
== Prognosis ==
Pineoblastomas are very aggressive tumors. 5-year survival for patients with pineoblastomas is around 58%.<ref name=":3" /> Prognosis for patients under 5 years old is lower, between 15 and 40%.<ref name=":0" /> Disseminated disease at diagnosis is also associated with worse outcomes. When pineoblastomas occur with retinoblastomas, the prognosis is typically worse, and these patients require more aggressive treatment.<ref name=":1" />
Complete gross tumor resection is associated with improved prognosis, but is difficult and rare to achieve. Radiation therapy after surgery is also linked to improved survival.<ref name=":0" />
== References ==
{{reflist}}
== External links ==
{{Medical resources
| DiseasesDB =
| ICD10 = C75.3
| ICD9 =
| ICDO = 9362/3
| OMIM =
| MedlinePlus =
| eMedicineSubj =
| eMedicineTopic =
| MeshID = D010871
}}
{{Endocrine gland neoplasia}}
[[Category:Endocrine neoplasia]]
[[Category:Brain tumor]]' |
Unified diff of changes made by edit (edit_diff ) | '@@ -44,5 +44,5 @@
== Diagnosis ==
[[File:Pineoblastoma_HE_x200.jpg|thumb|Histology of pineoblastoma]]
-Several imaging methods can be used to diagnosis pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.
+Several imaging methods can be used to diagnose pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.
Diagnosis also requires CSF sampling via lumbar puncture to assess for cytology and tumor markers.<ref name=":3" />
' |
New page size (new_size ) | 12093 |
Old page size (old_size ) | 12094 |
Size change in edit (edit_delta ) | -1 |
Lines added in edit (added_lines ) | [
0 => 'Several imaging methods can be used to diagnose pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.'
] |
Lines removed in edit (removed_lines ) | [
0 => 'Several imaging methods can be used to diagnosis pineoblastoma. Initially, urgent [[CT scan|CTs]] are recommended, followed by [[Magnetic resonance imaging|MR imaging]].<ref name=":3" /> CT will show large, multilobulated masses with heterogenous [[contrast enhancement]] and peripheral calcification of the pineal gland.<ref name=":1" /><ref name=":0" /> On MRI, pineoblastomas again appear as masses with heterogenous enhancement. They often appear hypo- to isointense on T1 and slightly hyperintense on T2-weighted images. Some areas of necrosis or hemorrhage may be seen as well. PET-CT has also been used in diagnosis, and shows increased uptake of fludeoxyglucose with pineoblastomas compared to other pineal masses.'
] |
Whether or not the change was made through a Tor exit node (tor_exit_node ) | false |
Unix timestamp of change (timestamp ) | '1671678222' |