gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Article

Send article

Dorsally exophytic brain stem glioma of the pineal region

Dorsal exophytisches Hirnstammgliom der Pinealisloge

Meeting Abstract

Search Medline for

  • corresponding author M.F. Oertel - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • T. Krings - Abteilung für Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • K. Nolte - Institut für Neuropathologie, Universitätsklinikum der RWTH Aachen
  • J. Weis - Institut für Neuropathologie, Universitätsklinikum der RWTH Aachen
  • J.M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen
  • M.H.T. Reinges - Neurochirurgische Klinik, Universitätsklinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 08.102

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc319.shtml

Published: May 8, 2006

© 2006 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Pineal gland lesions are rare and gliomas affecting this region are an exceptional finding. The authors report an unusual case of a dorsally exophytic brain stem astrocytoma arising in the pineal region and presenting with acute onset and haematoma.

Methods: A 16-year-old male was admitted comatose after acute onset and progressive diminution of vigilance. Cranial computed tomography showed a lesion of the pineal region causing occlusive hydrocephalus. After implantation of an external ventricle catheter to treat acute hydrocephalus, an additional magnetic resonance imaging disclosed a large tumour originating from the tectum and expanding dorsally into the pineal region. Microsurgical excision via a median suboccipital craniotomy and infratentorial-supracerebellar approach confirmed the diagnosis of a dorsally exophytic brain stem astrocytoma associated with tumour bleeding and led to resolution of the patients’ symptoms.

Results: A unique case of an initially unexpected dorsally exophytic brain stem glioma associated with haemorrhage and acute onset of symptoms is described that could be successfully treated and confirmed by microsurgery.

Conclusions: Unusual locations and appearances of dorsally exophytic brain stem gliomas may cause diagnostic difficulties. They have to be considered in differential diagnosis of lesions in the pineal region to allow adequate surgical treatment.